Healthcare Provider Details

I. General information

NPI: 1780314062
Provider Name (Legal Business Name): SHELBI C SMITH DNP, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S FRONT ST
HARRISBURG PA
17101-2010
US

IV. Provider business mailing address

PO BOX 858 MC CA410
HERSHEY PA
17033-0858
US

V. Phone/Fax

Practice location:
  • Phone: 717-782-5118
  • Fax: 717-782-5854
Mailing address:
  • Phone: 800-243-1455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN548911
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number548911
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: