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General NPI Number Information
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NPI Number | 1497270268
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Entity Type | Individual
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Provider Name | JENNIFER ROBIN SMITH FNP
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Gender | Female
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Dates
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Enumeration Date | 08/13/2017
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Last Update Date | 08/13/2017
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Provider Practice Location Address
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Address Line | 1793 13TH ST SE
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City | SALEM
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State | OR
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Zip | 97302-2541
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Country | US
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Telephone | 866-599-3376
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Fax |
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Provider Business Mailing Address
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Address Line | 19682 SW MURPHY ST
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City | ALOHA
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State | OR
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Zip | 97078-4331
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Country | US
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Telephone | 503-975-4931
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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 | 201706184NP-PP
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License Number State | OR
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