Individual
SHATERA NICOLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1125 MIRANDA LN, KISSIMMEE, FL 34741-0763
(689) 204-0153
Mailing address
1125 MIRANDA LN, KISSIMMEE, FL 34741-0763
(689) 204-0153
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
11015019
FL
Other
Enumeration date
10/22/2021
Last updated
05/25/2022
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