Individual
DANITA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
224 N HIGHWAY 67 ST, SUITE 252, FLORISSANT, MO 63031-5904
(314) 942-3272
(314) 584-2205
Mailing address
2040 WOODSON RD STE 204A, SAINT LOUIS, MO 63114-5697
(314) 942-3272
(314) 584-2205
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
152662
MO
291U00000X
Clinical Medical Laboratory
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1080096
—
MO
Enumeration date
01/10/2017
Last updated
11/17/2021
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