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Individual

AMBER SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
701 N 1ST ST, SPRINGFIELD, IL 62781-0001
(217) 788-3000
Mailing address
701 N 1ST ST, SPRINGFIELD, IL 62781-0001
(217) 788-3000

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209017237
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041408031
RN LICENSE
IL
01
209017237
APN LICENSE
IL
Enumeration date
01/29/2018
Last updated
02/12/2018
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