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Individual

JERRIE D SMITHWICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
3555 KNICKERBOCKER RD, SAN ANGELO, TX 76904-7610
(325) 949-9555
Mailing address
3555 KNICKERBOCKER RD, SAN ANGELO, TX 76904-7610
(325) 949-9555

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
454614
TX
364S00000X
Clinical Nurse Specialist
454614
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
454614
LICENSE
TX
Enumeration date
11/20/2007
Last updated
01/05/2012
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