Healthcare Provider Details

I. General information

NPI: 1932753316
Provider Name (Legal Business Name): CHLOE G SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2019
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 CCI DR NW
HUNTSVILLE AL
35805-2606
US

IV. Provider business mailing address

PO BOX 18428
HUNTSVILLE AL
35804-8428
US

V. Phone/Fax

Practice location:
  • Phone: 256-705-4224
  • Fax: 256-705-4135
Mailing address:
  • Phone: 256-705-4224
  • Fax: 256-705-4135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2076675
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: