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NPI Code Detail

MEDICARE: ANISSA LEEANN SMITH FNP-BC

MEDICARE: ANISSA LEEANN SMITH FNP-BC
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 Practitioner26NJ01016700NJ
2363LF0000XFamily Nurse Practitioner338734NY
3363LF0000XFamily Nurse Practitioner16999TN

General Provider Information

NPI Number : 1972855401
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANISSA LEEANN SMITH FNP-BC
Provider Business Mailing Address
First Line : 11 THEATRE CTR
Second Line :
City : SPARTA
State : NJ
Zip : 07871-2433
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11 THEATRE CTR
Second Line :
City : SPARTA
State : NJ
Zip : 07871-2433
Country : US
Telephone Number : 973-726-3219
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2012
Last Update Date : 04/12/2021

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Directions to “ ANISSA LEEANN SMITH FNP-BC” Practice Location

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