Individual
JENNIFER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN FNP
Contact information
Practice address
303 NW 11TH ST, FAIRFIELD, IL 62837-1206
(618) 842-4617
Mailing address
303 NW 11TH ST, FAIRFIELD, IL 62837-1206
(618) 842-4617
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209-031499
IL
363LF0000X
Family Nurse Practitioner
Primary
209-031499
IL
Other
Enumeration date
05/15/2025
Last updated
04/08/2026
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