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General NPI Number Information
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NPI Number | 1740743830
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Entity Type | Individual
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Provider Name | ABBEY SMITH MASK CRNP
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Gender | Female
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Dates
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Enumeration Date | 04/07/2019
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Last Update Date | 04/07/2019
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Provider Practice Location Address
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Address Line | 101 SIVLEY RD SW
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City | HUNTSVILLE
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State | AL
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Zip | 35801-4470
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Country | US
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Telephone | 256-265-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 29685 OXFORD CIR
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City | HARVEST
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State | AL
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Zip | 35749-7187
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Country | US
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Telephone | 334-332-7317
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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 | 1-172788
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License Number State | AL
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