MEDICARE: SHARI L SMITH FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1059153	TX

General Provider Information

NPI Number	:	1063173813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARI L SMITH FNP

Provider Business Mailing Address
First Line	:	421 PALMERO ST
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78404-1938
Country	:	US
Telephone Number	:	361-288-9276
Fax Number	:

Provider Business Practice Location Address
First Line	:	3213 HOLLY RD
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78415-3216
Country	:	US
Telephone Number	:	361-853-4300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2022
Last Update Date	:	01/04/2022

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