Healthcare Provider Details

I. General information

NPI: 1043608698
Provider Name (Legal Business Name): MARGARET MARIE SMITH CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2015
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 CONCORD RD
YORK PA
17402-9007
US

IV. Provider business mailing address

128 N POPLAR ST
ELIZABETHTOWN PA
17022-2029
US

V. Phone/Fax

Practice location:
  • Phone: 717-840-7594
  • Fax:
Mailing address:
  • Phone: 717-669-7275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP014526
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR223275
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP030240
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR223275
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: