Individual
EMILY ROSE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-1401
(321) 434-1667
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-1401
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APRN9367274
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN9367274
FL
363LF0000X
Family Nurse Practitioner
9367274
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116224700
—
FL
01
—
9367274
AANC
FL
01
—
NS822
FL MEDICARE
FL
Enumeration date
07/14/2011
Last updated
11/03/2023
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