Individual
HEATHER LEANNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1630 MASON AVE, DAYTONA BEACH, FL 32117-4500
(386) 238-9064
Mailing address
69 WHISPERING PINE DR, PALM COAST, FL 32164-7294
(386) 871-4491
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9314399
FL
363L00000X
Nurse Practitioner
Primary
APRN11019694
FL
363LF0000X
Family Nurse Practitioner
11019694
FL
Other
Enumeration date
05/16/2022
Last updated
03/07/2023
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