Individual
JESSICA MICHELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1180 OLD JACKSON RD, FARMINGTON, MO 63640-3428
(573) 760-1700
(573) 760-1224
Mailing address
4182 WARREN ST., BONNE TERRE, MO 63628
(573) 482-4156
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2013039119
MO
Other
Enumeration date
04/06/2023
Last updated
04/06/2023
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