Individual
RICKY EDWARD SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 HOSPITAL DR SW, HUNTSVILLE, AL 35801-6455
(256) 429-5071
(256) 429-4674
Mailing address
PO BOX 5538, FRESNO, CA 93755-5538
(559) 436-1000
(559) 354-4235
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-064233
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
BLUE CROSS BLUE SHIELD ALABAMA
—
05
—
PENDING
—
AL
Enumeration date
03/28/2012
Last updated
01/15/2013
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