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General NPI Number Information
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NPI Number | 1225030117
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Entity Type | Individual
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Provider Name | TERESA M SMITH NP
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Gender | Female
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 1101 HIGHWAY K STE A
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City | O FALLON
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State | MO
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Zip | 63366-8431
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Country | US
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Telephone | 314-687-2730
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 955534
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City | SAINT LOUIS
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State | MO
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Zip | 63195-7213
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 16181-33
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License Number State | WI
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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 | 619816
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 614734
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 149531
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License Number State | MO
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 149531
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License Number State | MO
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