Healthcare Provider Details

I. General information

NPI: 1740790658
Provider Name (Legal Business Name): ARLETTE SMITH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2017
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 CONSTITUTION AVE FL 5
MERIDIAN MS
39301-4001
US

IV. Provider business mailing address

1102 CONSTITUTION AVE
MERIDIAN MS
39301-4001
US

V. Phone/Fax

Practice location:
  • Phone: 601-703-5600
  • Fax:
Mailing address:
  • Phone: 601-508-3382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number902179
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF07230054
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: