Individual
SANDRA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
711 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-4717
(918) 207-0078
Mailing address
1825 E REPUBLIC RD APT 6-6203, SPRINGFIELD, MO 65804-6556
(888) 265-1068
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2002026983
MO
Other
Enumeration date
02/10/2026
Last updated
02/10/2026
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