Individual
MRS. WANDA G SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1910 JACKSON ST, MONROE, LA 71202
(318) 325-7998
(318) 398-4263
Mailing address
1910 JACKSON ST, MONROE, LA 71202-2532
(318) 325-7998
(318) 398-4263
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN097869
LA
163W00000X
Registered Nurse
RN182397
AZ
363LF0000X
Family Nurse Practitioner
Primary
AP09165
LA
363LF0000X
Family Nurse Practitioner
AP9660
AZ
Other
Enumeration date
08/20/2016
Last updated
08/09/2022
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