Healthcare Provider Details

I. General information

NPI: 1811852320
Provider Name (Legal Business Name): NICOLE KLAUS SMITH DNP, RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 BRUCE ST
YREKA CA
96097-3450
US

IV. Provider business mailing address

908 SOUTH ST
YREKA CA
96097-2724
US

V. Phone/Fax

Practice location:
  • Phone: 530-842-4121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number95037966
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: