Individual
PATRICIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
490B W ZIA RD STE 1, SANTA FE, NM 87505-7009
(505) 995-8346
Mailing address
19420 N 59TH AVE STE B233, GLENDALE, AZ 85308-6886
(505) 984-0356
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R34622
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R62054
LICENSE/ CERTIFICATION NUMBER
NM
Enumeration date
10/03/2011
Last updated
10/03/2011
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