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General NPI Number Information
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NPI Number | 1467865717
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Entity Type | Individual
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Provider Name | CORA L SMITH RN
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Gender | Female
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 13150 NE COUNTY ROAD 339
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City | TRENTON
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State | FL
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Zip | 32693-8852
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Country | US
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Telephone | 352-493-1962
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Fax |
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Provider Business Mailing Address
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Address Line | 13150 NE COUNTY ROAD 339
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City | TRENTON
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State | FL
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Zip | 32693-8852
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Country | US
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Telephone | 352-493-1962
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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 | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | RN0000187014
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | RN9334664
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License Number State | FL
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