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General NPI Number Information
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NPI Number | 1225323090
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Entity Type | Individual
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Provider Name | LORA MICHELLE SMITH FNP
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Gender | Female
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Dates
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Enumeration Date | 06/09/2011
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 2416 MOUNT PLEASANT RD
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City | HERNANDO
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State | MS
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Zip | 38632-2001
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Country | US
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Telephone | 662-298-3181
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Fax | 662-269-4704
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Provider Business Mailing Address
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Address Line | 2778 HIGHWAY 51 S
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City | SENATOBIA
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State | MS
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Zip | 38668-9403
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Country | US
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Telephone | 662-560-5966
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Fax | 662-560-5969
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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 | 15770
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License Number State | TN
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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 | R88-2467
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License Number State | MS
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