MEDICARE: TONIA SMITH APN

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	363L00000X	Nurse Practitioner	707199	TX

General Provider Information

NPI Number	:	1861638512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONIA SMITH APN

Provider Business Mailing Address
First Line	:	6777 CAMP BOWIE BLVD STE 100
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-7156
Country	:	US
Telephone Number	:	817-646-9699
Fax Number	:	817-259-2284

Provider Business Practice Location Address
First Line	:	6777 CAMP BOWIE BLVD STE 100
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-7156
Country	:	US
Telephone Number	:	817-646-9699
Fax Number	:	817-259-2284

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

Provider Enumeration Date	:	12/31/2008
Last Update Date	:	03/31/2025

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Directions to “ TONIA SMITH APN” Practice Location

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