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General NPI Number Information
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NPI Number | 1699353425
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Entity Type | Individual
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Provider Name | MELANIE ANNE SMITH
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Gender | Female
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Dates
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Enumeration Date | 04/01/2021
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 2890 W WALNUT ST STE 2
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City | ROGERS
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State | AR
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Zip | 72756-0335
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Country | US
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Telephone | 479-372-6201
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Fax |
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Provider Business Mailing Address
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Address Line | 4610 N ASHLAND AVE APT 1N
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City | CHICAGO
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State | IL
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Zip | 60640-5678
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Country | US
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Telephone |
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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 | 209023105
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 232243
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License Number State | AR
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