Individual
ANGELA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3132 CAMILLA CIR E, LAKE CORMORANT, MS 38641-1007
(901) 364-8610
(901) 364-8610
Mailing address
PO BOX 101, WALLS, MS 38680-0101
(901) 364-8610
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
930761
MS
Other
Enumeration date
03/21/2026
Last updated
03/21/2026
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