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General NPI Number Information
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NPI Number | 1588731749
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Entity Type | Individual
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Provider Name | MILDRED MARIE SMITH RN,MS, MN, PNP
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Gender | Female
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | CARL R. DARNALL ARMY MEDICAL CENTER 36000 DARNALL LOOP
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City | FORT HOOD
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State | TX
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Zip | 76544
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Country | US
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Telephone | 254-286-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 601 CHEETAH TRL
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City | HARKER HEIGHTS
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State | TX
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Zip | 76548-5621
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Country | US
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Telephone | 254-698-4163
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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 | 640264
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License Number State | TX
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