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NPI Code Detail

MEDICARE: MR. JEFFREY ALLEN SMITH APRN

MEDICARE: MR. JEFFREY ALLEN SMITH APRN
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
1363LF0000XFamily Nurse Practitioner160455MT

General Provider Information

NPI Number : 1205445095
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JEFFREY ALLEN SMITH APRN
Provider Business Mailing Address
First Line : 1518 CHOUTEAU ST
Second Line :
City : FORT BENTON
State : MT
Zip : 59442-9003
Country : US
Telephone Number : 406-622-5485
Fax Number : 406-622-5670
Provider Business Practice Location Address
First Line : 1518 CHOUTEAU ST
Second Line :
City : FORT BENTON
State : MT
Zip : 59442-9003
Country : US
Telephone Number : 406-622-5485
Fax Number : 406-622-5670
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2020
Last Update Date : 06/26/2023

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