Individual
OLIVIA NICOLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1311 E THOMAS RD, PHOENIX, AZ 85014-5707
(602) 322-1315
Mailing address
222 E JEFFERSON ST APT 1010, PHOENIX, AZ 85004-0410
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8985
AZ
Other
Enumeration date
03/18/2022
Last updated
03/21/2022
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