Individual
MONICA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
17610 N 17TH LN, PHOENIX, AZ 85023
(480) 255-6393
Mailing address
17610 N 17TH LN, PHOENIX, AZ 85023-2524
(480) 255-6393
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
AP 2759
AZ
363LA2200X
Adult Health Nurse Practitioner
Primary
AP2759
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
422237
—
AZ
Enumeration date
10/09/2007
Last updated
07/16/2018
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