Individual
HAZEL TAYLOR SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
4152 CALDERWOOD DR, SHREVEPORT, LA 71119-7622
(318) 221-8411
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
861
LA
363LA2200X
Adult Health Nurse Practitioner
RN038372-AP01083
LA
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
RN038372-AP01083
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
861
LICENSED PROFESSIONAL COU
LA
01
—
RN038372
RN LICENSE
LA
01
—
RN038372-AP01083
ADVANCE PRACTICE NURSE
LA
Enumeration date
08/15/2006
Last updated
03/23/2015
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