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Individual

MARGUERITE JEAN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
33 N CENTRAL AVE, SUITE 425, MEDFORD, OR 97501-5900
(541) 779-5877
(541) 664-3287
Mailing address
PO BOX 965, MEDFORD, OR 97501-0069
(541) 779-5877
(541) 664-3287

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
79042695
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
276809
OR
Enumeration date
12/03/2005
Last updated
03/19/2008
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