Individual
STEPHANIE D SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
921 GIBSON ST, TITUSVILLE, FL 32780-7721
(321) 747-7870
Mailing address
921 GIBSON ST, TITUSVILLE, FL 32780-7721
(321) 747-7870
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN9419141
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN9419141
—
FL
Enumeration date
03/23/2019
Last updated
03/23/2019
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