Individual
MRS. PHYLLIS J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6701 N CHARLES ST, TOWSON, MD 21204-6808
(410) 296-4616
(410) 337-5068
Mailing address
110 WEST RD, SUITE 210, TOWSON, MD 21204-2316
(410) 296-4616
(410) 337-5068
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
119768
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
RN48155
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000828100
—
MD
05
—
8050134
—
NC
05
—
NAN771
—
SC
Enumeration date
08/21/2006
Last updated
12/28/2010
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