Individual
SHARON DIANNE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
129 HOLTON RD, MIDWAY, FL 32343-6511
(229) 474-1904
Mailing address
1810 MERIADOC RD, TALLAHASSEE, FL 32303-3349
(229) 474-1904
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
20181534P
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L19000019265
—
FL
Enumeration date
02/02/2019
Last updated
02/02/2019
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