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Individual

ELIZABETH D SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP, ANP-C

Contact information

Practice address
300 ESSJAY RD, WILLIAMSVILLE, NY 14221-8208
(716) 445-2013
(716) 839-6740
Mailing address
300 ESSJAY RD, WILLIAMSVILLE, NY 14221-8208
(716) 445-2013
(716) 839-6740

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
415198
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F305061
NY
363LP0200X
Pediatric Nurse Practitioner
F381387
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00027840501
UNIVERA
01
000560590002
BC/BS
05
02345462
NY
01
061212000042
FIDELIS
01
9512029
IHA
Enumeration date
10/25/2006
Last updated
04/29/2024
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