Individual
JUANITA M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
573 MIDWOOD DR, BRICK, NJ 08724-4739
(732) 773-5919
Mailing address
573 MIDWOOD DR, BRICK, NJ 08724-4739
(732) 773-5919
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
26NJ01174300
NJ
363LG0600X
Gerontology Nurse Practitioner
Primary
26NJ01174300
NJ
Other
Enumeration date
10/13/2021
Last updated
10/13/2021
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