Individual
JANE S. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-3064
(417) 820-8862
Mailing address
709 N JUSTICE ST, STE A, HENDERSONVILLE, NC 28791-3455
(828) 697-7377
(828) 697-7380
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2012028464
MO
363LF0000X
Family Nurse Practitioner
Primary
5014826
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
08/15/2012
Last updated
09/21/2021
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