Individual
MR. BRENT LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ANP
Contact information
Practice address
2730 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-5939
(337) 988-1585
(337) 981-4694
Mailing address
PO BOX 4176, HOUMA, LA 70361-4176
(985) 872-5864
(985) 872-0317
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN087084 - AP06269
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2142607
—
LA
Enumeration date
06/02/2010
Last updated
05/28/2011
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