Healthcare Provider Details

I. General information

NPI: 1770942500
Provider Name (Legal Business Name): HILARY SMITH DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2016
Last Update Date: 05/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2775 S 8TH AVE
YUMA AZ
85364-7110
US

IV. Provider business mailing address

2775 S 8TH AVE
YUMA AZ
85364-7110
US

V. Phone/Fax

Practice location:
  • Phone: 928-341-0700
  • Fax: 928-341-0900
Mailing address:
  • Phone: 928-341-0700
  • Fax: 928-341-0900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP8479
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: