Individual
MARK ALAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.R.N.P.
Contact information
Practice address
2211 LOMAS BLVD NE, 2ND FLOOR, ALBUQUERQUE, NM 87106-2719
(505) 272-2336
(505) 272-5103
Mailing address
933 BRADBURY DR SE, SUITE 2222, ALBUQUERQUE, NM 87106-4374
(505) 272-3102
(505) 272-8060
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-02648
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009585500
—
FL
01
—
U3150Y
MEDICARE #
FL
Enumeration date
09/04/2013
Last updated
05/21/2015
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