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NPI Code Detail

MEDICARE: NICOLE SHARRON SMITH FNP-C

MEDICARE: NICOLE SHARRON SMITH FNP-C
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
1363L00000XNurse Practitioner219371AZ

General Provider Information

NPI Number : 1720550809
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE SHARRON SMITH FNP-C
Provider Business Mailing Address
First Line : PO BOX 6610
Second Line :
City : CHANDLER
State : AZ
Zip : 85246-6610
Country : US
Telephone Number : 480-926-7800
Fax Number :
Provider Business Practice Location Address
First Line : 2836 E INDIAN SCHOOL RD STE A8
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-6864
Country : US
Telephone Number : 602-840-0056
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2018
Last Update Date : 08/29/2023

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Directions to “ NICOLE SHARRON SMITH FNP-C” Practice Location

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