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Provider Information for 1912928748

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

NANCY J. SMITH ARNP

Gender: FEMALE

Individual NPI: 1912928748

Calendar   Last Updated:  2020-03-05
  Certification Date:  2020-03-05

Details

Name Value
NPI 1912928748
Enumeration Date 2006-07-21
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 270 MAIN ST N STE 300
STILLWATER, MN 55082-6788
United States

Phone: 651-342-1039 | Fax: 651-342-1428
View Map External Link
Primary Practice Address 10150 HIGHLAND MANOR DR STE 240
TAMPA, FL 33610
United States

Phone: 813-259-1013 | Fax:
View Map External Link
Secondary Practice Address 300 S HYDE PARK AVE STE. 210
TAMPA, FL 33606-2286
United States

Phone: 813-259-1013 | Fax: 813-254-0396
View Map External Link

300 S HYDE PARK AVE STE. 210
TAMPA, FL 33606-2286
United States

Phone: 813-259-1013 | Fax: 813-254-0396
View Map External Link

Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID FL 3047768 00
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 363LA2200X - Nurse Practitioner Adult Health FL ARNP1378202