Individual
MS. AMANDA NICHOLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1245 WILSHIRE BLVD, STE 703, LOS ANGELES, CA 90017-4807
(213) 977-7422
(213) 250-8945
Mailing address
1245 WILSHIRE BLVD, STE 703, LOS ANGELES, CA 90017-4807
(213) 977-7422
(213) 250-8945
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP16728
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN603014
—
CA
Enumeration date
10/16/2006
Last updated
11/09/2007
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