Individual
NICOLE R SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
19228 NW COUNTY ROAD 12, BRISTOL, FL 32321-4102
(850) 544-6459
Mailing address
19228 NW COUNTY ROAD 12, BRISTOL, FL 32321-4102
(850) 544-6459
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
PN5265905
FL
Other
Enumeration date
02/24/2025
Last updated
02/24/2025
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