Individual
TANYA ELAINE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGANCP-BC
Contact information
Practice address
3269 N STOCKTON HILL RD, KINGMAN, AZ 86409-3619
(928) 757-2102
Mailing address
3269 N STOCKTON HILL RD, KINGMAN, AZ 86409-3619
(928) 757-2101
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP10770
AZ
Other
Enumeration date
12/12/2017
Last updated
12/12/2017
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