Individual
JENNIFER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
1905 SW H K DODGEN LOOP, TEMPLE, TX 76502-1814
(254) 298-2465
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
API138941
TX
Other
Enumeration date
09/27/2018
Last updated
09/23/2020
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