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NPI Code Detail

MEDICARE: PATRICIA SMITH

MEDICARE:   PATRICIA  SMITH
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
1104100000XSocial WorkerNV

General Provider Information

NPI Number : 1912305822
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA SMITH
Provider Business Mailing Address
First Line : 4921 TEAL PETALS ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89081-2690
Country : US
Telephone Number : 318-537-1521
Fax Number :
Provider Business Practice Location Address
First Line : 4921 TEAL PETALS ST
Second Line : 4921 TEAL PETALS
City : NORTH LAS VEGAS
State : NV
Zip : 89081-2690
Country : US
Telephone Number : 318-537-1521
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2014
Last Update Date : 12/09/2014

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Directions to “ PATRICIA SMITH ” Practice Location

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