Individual
EDWINNA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1415 WATTS ST, SAYRE, OK 73662-1310
(580) 928-2044
Mailing address
1901 W 3RD ST STE C, ELK CITY, OK 73644-4340
(580) 339-8001
(580) 339-8031
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0075474
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200130310A
—
OK
Enumeration date
11/01/2007
Last updated
10/25/2017
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