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Individual

ANGELA ELAINE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP

Contact information

Practice address
8331 N DAVIS HWY, PENSACOLA, FL 32514-6094
(850) 505-4700
(850) 505-4711
Mailing address
10140 CENTURION PKWY N, JACKSONVILLE, FL 32256-0532
(904) 697-4100
(904) 697-5102

Taxonomy

Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
APRN9473715
FL
363L00000X
Nurse Practitioner
APRN9473715
FL
363LP0200X
Pediatric Nurse Practitioner
130810
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
023348800
FL
Enumeration date
05/02/2008
Last updated
04/26/2019
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