Healthcare Provider Details

I. General information

NPI: 1407894793
Provider Name (Legal Business Name): DEBORAH E. ARNOLD SMITH CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 01/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ORLEANS ST BLOOMBERG 7218
BALTIMORE MD
21287-0006
US

IV. Provider business mailing address

1800 ORLEANS STREET, BLOOMBERG 7218
BALTIMORE MD
21287-0006
US

V. Phone/Fax

Practice location:
  • Phone: 410-502-4937
  • Fax: 410-614-8238
Mailing address:
  • Phone: 410-502-4937
  • Fax: 410-614-8238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR094986
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: