Healthcare Provider Details

I. General information

NPI: 1053744748
Provider Name (Legal Business Name): MARY U SMITH N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2013
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WALTER REED NATIONAL MILITARY MEDICAL CENTER 4494 PALMER RD N
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

WALTER REED NATIONAL MILITARY MEDICAL CENTER 4494 PALMER RD N
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-319-2101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-1613
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: