Individual
BLAIR KENNEDY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, APRN, FNP-C
Contact information
Practice address
2449 HOSPITAL DR STE 200, BOSSIER CITY, LA 71111-1905
(318) 212-7841
Mailing address
760 SOUTHERN TRACE PKWY, SHREVEPORT, LA 71106-9325
(318) 230-4980
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
221579
LA
363L00000X
Nurse Practitioner
Primary
221579
LA
363LF0000X
Family Nurse Practitioner
221579
LA
Other
Enumeration date
10/06/2021
Last updated
10/03/2024
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