Individual
DR. SEAN M. SMART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
300 E JEFFERSON ST STE 101, BOISE, ID 83712-6221
(208) 322-1680
Mailing address
2506 N 30TH ST, BOISE, ID 83703-5429
(207) 730-1725
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53509
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53509
IDAHO NP LICENSE
ID
01
—
N41662
IDAHO RN LICENSE
ID
01
—
RN54644
MAINE RN LICENSE
ME
Enumeration date
04/15/2016
Last updated
06/22/2016
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