Individual
CRISELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
400 SOLDIER CREEK DR, ROSEBUD, SD 57570-8502
(605) 747-2231
Mailing address
PO BOX 400, ROSEBUD, SD 57570-0400
(605) 747-2231
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP3485
AZ
363LF0000X
Family Nurse Practitioner
NP-07426
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
339468
—
AZ
Enumeration date
11/22/2006
Last updated
08/06/2019
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