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General NPI Number Information
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NPI Number | 1073091427
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Entity Type | Individual
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Provider Name | JOSEPH G SMITH DNP, FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 07/29/2018
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Last Update Date | 08/17/2021
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Provider Practice Location Address
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Address Line | 9177 RIDGETOP BLVD NW
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City | SILVERDALE
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State | WA
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Zip | 98383-8519
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Country | US
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Telephone | 360-307-6920
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 282
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City | SUQUAMISH
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State | WA
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Zip | 98392-0282
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Country | US
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Telephone | 360-509-8476
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | RN60225557
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60896900
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License Number State | WA
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