Healthcare Provider Details

I. General information

NPI: 1154537975
Provider Name (Legal Business Name): MELANIE ELIZABETH SMITH ACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 05/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 FANNIN ST
HOUSTON TX
77030-2703
US

IV. Provider business mailing address

6565 FANNIN ST ALKEK 754
HOUSTON TX
77030-2703
US

V. Phone/Fax

Practice location:
  • Phone: 713-441-4595
  • Fax:
Mailing address:
  • Phone: 713-441-4565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number724604
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: