Individual
JENNIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1270 KOTNUM ROAD, WARM SPRINGS HEALTH AND WELLNESS CENTER, WARM SPRINGS, OR 97741
(541) 553-2478
Mailing address
P.O. BOX 1209, WARM SPRINGS HEALTH AND WELLNESS CENTER, WARM SPRINGS, OR 97741
(541) 553-2478
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
000028103N1
OR
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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