Individual
LEANNA MARIE BROOKS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2900 DOOLITTLE DRIVE, ELLSWORTH AIR FORCE BASE, SD 57760
(605) 385-3111
Mailing address
2900 DOOLITTLE DRIVE, ATTEN MEDICAL STAFF SERVICES, ELLSWORTH AIR FORCE BASE, SD 57706
(605) 385-3111
(605) 385-3680
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CP000344
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP000344
LICENSE
SD
Enumeration date
11/04/2005
Last updated
05/03/2018
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