Healthcare Provider Details

I. General information

NPI: 1821302811
Provider Name (Legal Business Name): LORI HARWOOD SMITH CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LORI GRAHAM HARWOOD CRNA

II. Dates (important events)

Enumeration Date: 08/02/2010
Last Update Date: 07/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8383 N DAVIS HWY
PENSACOLA FL
32514-6039
US

IV. Provider business mailing address

8383 N DAVIS HWY
PENSACOLA FL
32514-6039
US

V. Phone/Fax

Practice location:
  • Phone: 850-494-6098
  • Fax: 850-494-5150
Mailing address:
  • Phone: 850-494-6098
  • Fax: 850-494-5150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9322402
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number15144
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: