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Individual

SANDRA SMITH

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
801 S ADAMS ST, PETERSBURG, VA 23803-5133
(804) 862-5000
(804) 862-5948
Mailing address
DEPT 1041 PO BOX 740209, ATLANTA, GA 30374-0209
(941) 360-1566
(941) 358-9818

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024156957
VA

Other

Enumeration date
04/04/2006
Last updated
07/08/2007
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