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General NPI Number Information
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NPI Number | 1467613562
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Entity Type | Individual
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Provider Name | CHANDRA DIONE SMITH APRN, CPNP
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Gender | Female
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | 1201 BISHOP STREET PROFESSIONAL BLDG #4
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City | LITTLE ROCK
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State | AR
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Zip | 72202
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Country | US
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Telephone | 501-364-1004
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Fax | 501-364-6291
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Provider Business Mailing Address
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Address Line | 2701 W 27TH AVE
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City | PINE BLUFF
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State | AR
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Zip | 71603-4945
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Country | US
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Telephone | 501-425-8827
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | A03124
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP130993
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 23850
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | A003124
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License Number State | AR
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