Individual
SHANIECE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8301 HARCOURT RD STE 200, INDIANAPOLIS, IN 46260-2082
(317) 415-6600
(317) 415-6649
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(239) 236-2775
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71009045A
IN
363LF0000X
Family Nurse Practitioner
F09181038
IN
Other
Enumeration date
12/10/2018
Last updated
09/20/2024
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