Individual
PANDORA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1106 ANNAPOLIS RD STE 310, ODENTON, MD 21113-1744
(410) 874-1400
Mailing address
1106 ANNAPOLIS RD STE 310, ODENTON, MD 21113-1744
(410) 874-1400
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1030660
TX
363LF0000X
Family Nurse Practitioner
Primary
AC005646
MD
363LF0000X
Family Nurse Practitioner
APRN-2880
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
429198101
—
TX
01
—
429198102
CSHCN
TX
Enumeration date
06/10/2020
Last updated
06/14/2024
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