Individual
CELESTINE DEMETRICH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
580 W 8TH ST, UFJP - DEPT, OF NEUROSURGERY, JACKSONVILLE, FL 32209-6533
(904) 244-3950
(904) 244-9437
Mailing address
PO BOX 44008, UFJP - PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3199
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP9177923
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003121269A
—
GA
05
—
0045419-00
—
FL
Enumeration date
02/20/2012
Last updated
08/09/2012
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