Individual
ELISA BROOKE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6100 HARBOURSIDE CENTRE LOOP, MIDLOTHIAN, VA 23112-2170
(804) 639-7555
Mailing address
25892 N JAMES MADISON HIGHWAY, NEW CANTON, VA 23123-0220
(434) 581-3271
(434) 581-1105
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024170177
VA
363LF0000X
Family Nurse Practitioner
Primary
0024170177
VA
Other
Enumeration date
09/14/2012
Last updated
12/03/2024
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