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General NPI Number Information
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NPI Number | 1205365715
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Entity Type | Individual
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Provider Name | EMILY SMITH CNM, WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 03/15/2019
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Provider Practice Location Address
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Address Line | 2051 MARENGO ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-1352
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Country | US
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Telephone | 323-409-1416
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Fax |
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Provider Business Mailing Address
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Address Line | 2051 MARENGO ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-1352
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Country | US
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Telephone | 323-409-1416
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 95006527
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 235862
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License Number State | CA
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