Healthcare Provider Details

I. General information

NPI: 1629792866
Provider Name (Legal Business Name): SARAH LEANN SMITH CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2022
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 FLYWAY VIEW LN
ALABASTER AL
35007-1123
US

IV. Provider business mailing address

1075 FLYWAY VIEW LN
ALABASTER AL
35007-1123
US

V. Phone/Fax

Practice location:
  • Phone: 256-276-1589
  • Fax:
Mailing address:
  • Phone: 256-276-1589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-162169
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-162169
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: