Individual
MISS CHANDRA NICOLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
6000 E. STATE STREET, 1ST FLOOR PROMEDICA HOSPICE, ROCKFORD, IL 61108
(815) 977-9251
(866) 224-1731
Mailing address
6000 E. STATE STREET, 1ST FLOOR PROMEDICA HOSPICE, ROCKFORD, IL 61108
(815) 977-9251
(866) 224-1731
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.402882
IL
363LF0000X
Family Nurse Practitioner
209.016769
IL
363LF0000X
Family Nurse Practitioner
Primary
277.001193
IL
Other
Enumeration date
01/04/2018
Last updated
07/20/2022
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