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General NPI Number Information
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NPI Number | 1437971819
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Entity Type | Individual
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Provider Name | TERESA SMITH NP
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Gender | Female
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 6401 AMERICA BLVD STE 200
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City | HYATTSVILLE
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State | MD
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Zip | 20782-2357
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Country | US
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Telephone | 202-546-4504
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Fax |
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Provider Business Mailing Address
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Address Line | 1931 GRAND WAY BLVD APT 410
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City | BOWIE
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State | MD
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Zip | 20721-2175
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Country | US
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Telephone | 240-393-5797
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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 | R228481
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License Number State | MD
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