Individual
EDNA DIANA SMILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2420 CHASE PARK DR APT F, MONTGOMERY, AL 36110-3052
(334) 333-7762
Mailing address
2420 CHASE PARK DR APT F, MONTGOMERY, AL 36110-3052
(334) 333-7762
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
1-191014
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1217
BIRTHDAY
AL
Enumeration date
07/19/2022
Last updated
07/19/2022
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