Individual
MARISSA KELLY MARTI-SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P
Contact information
Practice address
3410 WORTH ST STE 400, DALLAS, TX 75246
(214) 370-1000
(214) 370-1085
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-0813
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP138524
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
AP138524
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
392915001
—
TX
Enumeration date
11/08/2018
Last updated
12/06/2021
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