Healthcare Provider Details

I. General information

NPI: 1992030696
Provider Name (Legal Business Name): DAWN SMITH WALSH APRN, AGNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DAWN SMITH

II. Dates (important events)

Enumeration Date: 10/14/2009
Last Update Date: 06/29/2025
Certification Date: 06/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14910 N. DALE MABRY HWY # 342203
TAMPA FL
33618
US

IV. Provider business mailing address

14910 N DALE MABRY HWY # 342203
TAMPA FL
33618-1814
US

V. Phone/Fax

Practice location:
  • Phone: 813-820-4828
  • Fax: 813-820-4977
Mailing address:
  • Phone: 813-820-4828
  • Fax: 813-820-4977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11006514
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN11006514
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11006514
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: