MEDICARE: HEIDI 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	201906193RN	OR

General Provider Information

NPI Number	:	1346175478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI SMITH FNP

Provider Business Mailing Address
First Line	:	59648 JASPER PL
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97702-9650
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	59648 JASPER PL
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97702-9650
Country	:	US
Telephone Number	:	253-678-5791
Fax Number	:

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

Provider Enumeration Date	:	06/18/2026
Last Update Date	:	06/18/2026

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Directions to “ HEIDI SMITH FNP” Practice Location

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