Individual
JESSICA CARMEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
11806 N 87TH AVE, PEORIA, AZ 85345-8125
(623) 487-5100
Mailing address
3525 E LIBERTY LN, PHOENIX, AZ 85048-7864
(256) 601-1944
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
NUR-RN-LIC-161397
MT
Other
Enumeration date
11/16/2021
Last updated
11/16/2021
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