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General NPI Number Information
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NPI Number | 1235604356
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Entity Type | Individual
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Provider Name | LAURA CHRISTINE SMITH FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/04/2018
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Last Update Date | 10/04/2018
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Provider Practice Location Address
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Address Line | 1131 MAIN ST
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City | ALAMOSA
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State | CO
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Zip | 81101-2446
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Country | US
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Telephone | 719-580-8630
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Fax |
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Provider Business Mailing Address
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Address Line | 11416 CR FF
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City | BLANCA
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State | CO
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Zip | 81123
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Country | US
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Telephone | 719-580-8630
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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 | APN.0994196-NP
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License Number State | CO
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