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Individual

NEVA J SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
4370 W MAIN ST, DOTHAN, AL 36305
(334) 793-5000
(334) 615-8419
Mailing address
PO BOX 6907, DOTHAN, AL 36302
(334) 793-5000
(334) 615-8419

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1023804
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05406067
MEDICAID
MS
01
1771422
MEDICAID
LA
01
51515687
BCBS OF ALABAMA
AL
01
P00057800
RR MCARE
Enumeration date
03/31/2006
Last updated
07/08/2007
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