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General NPI Number Information
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NPI Number | 1457098709
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Entity Type | Individual
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Provider Name | DANIELLE SMITH REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 05/18/2022
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 19186 MS HIGHWAY 17
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City | COILA
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State | MS
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Zip | 38923-9691
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Country | US
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Telephone | 662-897-8633
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Fax |
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Provider Business Mailing Address
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Address Line | 19186 MS HIGHWAY 17
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City | COILA
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State | MS
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Zip | 38923-9691
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Country | US
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Telephone | 662-897-8633
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 918871
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License Number State | MS
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