Healthcare Provider Details

I. General information

NPI: 1265461677
Provider Name (Legal Business Name): NAOMI RUTH SMITH D.N.P., APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 TOWER DR STE 406
MONROE LA
71201-5783
US

IV. Provider business mailing address

PO BOX 1089
HAMMOND LA
70404-1089
US

V. Phone/Fax

Practice location:
  • Phone: 318-374-7370
  • Fax: 318-362-8669
Mailing address:
  • Phone: 985-892-7070
  • Fax: 985-892-7017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP04245
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: