Individual
JENNIFER SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2120 SARNO RD, MELBOURNE, FL 32935-3084
(321) 241-6800
(321) 241-6890
Mailing address
PO BOX 1137, MELBOURNE, FL 32902-1137
(321) 952-9696
(321) 952-7937
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
RN235782
GA
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN11018703
FL
Other
Enumeration date
03/08/2019
Last updated
08/03/2023
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