Individual
LARRY EDWIN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
768 N US HIGHWAY 41, ROCKVILLE, IN 47872-7091
(812) 360-0047
Mailing address
3155 W 57TH ST, INDIANAPOLIS, IN 46228-1609
(812) 360-0047
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71010467A
IN
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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