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General NPI Number Information
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NPI Number | 1477960987
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Entity Type | Individual
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Provider Name | TERRY SMITH MS,APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/16/2014
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Last Update Date | 10/21/2019
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Provider Practice Location Address
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Address Line | 3150 N WINDING BROOK RD
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-0972
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Country | US
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Telephone | 928-556-0060
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Fax | 928-556-0015
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Provider Business Mailing Address
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Address Line | 2772 W PICO DEL MONTE CIR
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-9197
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Country | US
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Telephone | 928-556-0060
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Fax | 928-556-0015
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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 | TAP5702
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License Number State | AZ
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