Individual
MRS. BONNIE JO SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 388-5503
Mailing address
82 WHITE OAK DR, RED HOUSE, WV 25168-9600
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
51534
WV
Other
Enumeration date
12/16/2009
Last updated
03/13/2024
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