Individual
NICOLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2500 NE NEFF RD, BEND, OR 97701-6015
(541) 388-4333
(541) 388-3446
Mailing address
PO BOX 6048, BEND, OR 97708-6048
(541) 382-4900
(541) 706-2398
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201905762NP-PP
OR
363LF0000X
Family Nurse Practitioner
5008394
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500788384
—
OR
Enumeration date
02/29/2016
Last updated
04/03/2026
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