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Individual

HEATHER SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
1190 PELICAN BAY DR, DAYTONA BEACH, FL 32119-1381
(386) 206-8069
(386) 206-8069
Mailing address
1838 FOROUGH CIR, PORT ORANGE, FL 32128-6016
(386) 348-4200
(839) 600-9980

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0024194804
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APRN.CNP.0040119
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11033249
FL

Other

Enumeration date
06/06/2024
Last updated
03/17/2026
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