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General NPI Number Information
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NPI Number | 1033647144
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Entity Type | Individual
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Provider Name | KEONA E SMITH NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 06/02/2017
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 6015 E BROWN RD
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City | MESA
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State | AZ
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Zip | 85205-4452
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Country | US
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Telephone | 866-389-2727
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Fax |
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Provider Business Mailing Address
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Address Line | 10707 W CAMELBACK RD
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City | PHOENIX
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State | AZ
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Zip | 85037-5073
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Country | US
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Telephone | 623-872-5316
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2017015826
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | APRN-213691
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | APRN-4030
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License Number State | HI
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 10022091
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 207307
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License Number State | AK
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11227
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License Number State | MN
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 13280148-4
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License Number State | UT
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 209027284
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License Number State | IL
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Taxonomy #9
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 95025330
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License Number State | CA
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Taxonomy #10
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 253724
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License Number State | AZ
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Taxonomy #11
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 72170
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License Number State | NM
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