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General NPI Number Information
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NPI Number | 1336759943
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Entity Type | Individual
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Provider Name | TANYA RENEE SMITH MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/07/2020
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Last Update Date | 03/21/2022
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Provider Practice Location Address
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Address Line | 13105 ELK MOUNTAIN DR
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City | RIVERVIEW
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State | FL
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Zip | 33579-7184
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Country | US
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Telephone | 813-681-6537
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Fax | 813-741-1204
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Provider Business Mailing Address
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Address Line | 13105 ELK MOUNTAIN DR
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City | RIVERVIEW
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State | FL
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Zip | 33579-7184
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Country | US
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Telephone | 813-681-6537
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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 | APRN11004296
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License Number State | FL
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