Individual
MRS. THERESA MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CRNP-BC
Contact information
Practice address
833 CHESTNUT ST, PHILADELPHIA, PA 19107
(267) 496-2344
Mailing address
4240 FRONTIER RD, HATBORO, PA 19040
(267) 496-2344
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP007219
PA
Other
Enumeration date
09/13/2010
Last updated
09/13/2010
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