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General NPI Number Information
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NPI Number | 1104430552
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Entity Type | Individual
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Provider Name | ROBERT NATHAN SMITH NP
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Gender | Male
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Dates
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Enumeration Date | 09/03/2020
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 13100 RIVER RD STE 100
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City | DESTREHAN
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State | LA
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Zip | 70047-5216
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Country | US
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Telephone | 985-235-0010
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Fax | 985-764-1310
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Provider Business Mailing Address
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Address Line | 13100 RIVER RD STE 100
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City | DESTREHAN
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State | LA
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Zip | 70047-5216
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Country | US
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Telephone | 985-235-0010
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Fax | 985-764-1310
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SMIT-IY8V6O
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License Number State | MS
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