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General NPI Number Information
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NPI Number | 1083428908
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Entity Type | Individual
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Provider Name | CARISSA LYNN SMITH PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 5981 SMITH VALLEY RD
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City | LAS VEGAS
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State | NV
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Zip | 89148-1499
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Country | US
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Telephone | 419-577-2853
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Fax |
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Provider Business Mailing Address
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Address Line | 5981 SMITH VALLEY RD
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City | LAS VEGAS
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State | NV
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Zip | 89148-1499
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Country | US
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Telephone | 419-577-2853
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 20094
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 87145
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03131707
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License Number State | OH
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