Individual
AMY M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
1020 D A BIGLANE DR, BROOKHAVEN, MS 39601-2331
(601) 823-8000
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
(660) 826-4852
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R853291
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08336062
—
MS
Enumeration date
07/03/2006
Last updated
11/03/2010
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