Individual
LORETTA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 556-7717
(573) 556-7723
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
(573) 556-7717
(573) 556-7723
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
152411
MO
363L00000X
Nurse Practitioner
Primary
R 103113-3
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
423931724
—
MO
01
—
437082
HEALTHLINK
MO
01
—
CD6059
RAILROAD GROUP
MO
01
—
P00192762
MEDICARE RAILROAD
MO
Enumeration date
06/09/2006
Last updated
05/28/2013
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