Individual
JAMIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4121 VETERANS MEMORIAL DR, MOUNT VERNON, IL 62864-6262
(618) 242-3778
Mailing address
4121 VETERANS MEMORIAL DR, MOUNT VERNON, IL 62864-6262
(618) 242-3778
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209015749
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209015749
APN LICENSE
IL
Enumeration date
03/15/2017
Last updated
03/15/2017
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