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Individual

AMANDA SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1411 COLLEGE DR, TEXARKANA, TX 75503-3533
(903) 791-1110
(903) 791-9353
Mailing address
PO BOX 1326, MARSHALL, TX 75671-1326
(903) 927-3782
(903) 927-1764

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
123648
AR
363LF0000X
Family Nurse Practitioner
Primary
AP144505
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
123648
LICENSE
AR
01
AP144505
LICENSE
TX
Enumeration date
01/22/2020
Last updated
04/18/2023
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