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Individual

PATRICIA SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
409 W 400 S, SALT LAKE CITY, UT 84101-1135
(802) 364-0058
Mailing address
107 B ST APT 402, SALT LAKE CITY, UT 84103-2449

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
687210
NY
363LF0000X
Family Nurse Practitioner
Primary
10121583-4405
UT
363LF0000X
Family Nurse Practitioner
9426325
NY

Other

Enumeration date
03/02/2016
Last updated
09/30/2020
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