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Individual

STACY SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, RN, CPNP-PC

Contact information

Practice address
5345 FM 3 S, MARQUEZ, TX 77865-4303
(979) 229-9688
Mailing address
5345 FM 3 S, MARQUEZ, TX 77865-4303

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
AP139260
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
AP139260
TX

Other

Enumeration date
12/27/2018
Last updated
10/09/2024
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