Individual
MRS. JACQUELYN LYON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2740 HEADLAND AVE, DOTHAN, AL 36303-1236
(334) 792-1100
(334) 671-4168
Mailing address
2740 HEADLAND AVE, DOTHAN, AL 36303-1236
(334) 792-1100
(334) 671-4168
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-116383
AL
Other
Enumeration date
07/27/2015
Last updated
07/27/2015
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