Individual
JILLIAN R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
45 READE PL, POUGHKEEPSIE, NY 12601-3947
(845) 431-5629
(703) 890-2650
Mailing address
11781 LEE JACKSON MEMORIAL HWY, SUITE 550, FAIRFAX, VA 22033-3309
(571) 777-5173
(703) 890-2650
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
054519
ME
367500000X
Certified Registered Nurse Anesthetist
200360008CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
725990
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
298058
—
OR
Enumeration date
05/31/2006
Last updated
03/07/2017
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