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Individual

ELAINE MELISSA SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
9692 PENNSYLVANIA AVE, UPPER MARLBORO, MD 20772-3670
(301) 599-0300
Mailing address
9692 PENNSYLVANIA AVE, UPPER MARLBORO, MD 20772-3670
(301) 599-0300

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R106865
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
798100700
MD
Enumeration date
11/17/2006
Last updated
11/17/2011
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