Individual
MARY GENENVIEVE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC, NNP
Contact information
Practice address
1150 N INDIAN CANYON DR, PALM SPRINGS, CA 92262-4872
(760) 323-6430
Mailing address
69696 PLEASANT GRV, CATHEDRAL CITY, CA 92234-2542
(760) 770-3716
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
376530
CA
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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