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General NPI Number Information
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NPI Number | 1700709219
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Entity Type | Organization
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Legal Business Name | SMILING LLAMA LLC
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Dates
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Enumeration Date | 08/01/2026
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Last Update Date | 08/01/2026
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Provider Practice Location Address
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Address Line | 790 HILL LN
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City | BRACEY
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State | VA
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Zip | 23919-2174
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Country | US
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Telephone | 919-995-5421
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Fax | 903-213-9122
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Provider Business Mailing Address
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Address Line | PO BOX 378
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City | BRACEY
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State | VA
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Zip | 23919-0378
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Country | US
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Telephone | 919-995-5421
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Fax | 903-213-9122
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. LORI DILLARD FUQUAY
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Credential | FNP
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Telephone | 919-995-5421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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