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General NPI Number Information
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NPI Number | 1225856578
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Entity Type | Individual
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Provider Name | HANNA SMITH
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Gender | Female
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Dates
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Enumeration Date | 09/26/2024
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 761 JUSTIN RD STE C
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City | ROCKWALL
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State | TX
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Zip | 75087-4877
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Country | US
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Telephone | 214-351-3490
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Fax |
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Provider Business Mailing Address
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Address Line | 276 DEVONPORT DR
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City | ROCKWALL
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State | TX
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Zip | 75032-0195
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Country | US
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Telephone | 812-629-7166
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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