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General NPI Number Information
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NPI Number | 1770651176
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Entity Type | Individual
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Provider Name | DONNA FAYE SMITH R.N., F.N.P.
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Gender | Female
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 05/09/2017
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Provider Practice Location Address
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Address Line | 72780 COUNTRY CLUB DR BLDG B 203B
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-4126
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Country | US
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Telephone | 760-674-3847
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Fax |
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Provider Business Mailing Address
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Address Line | 72780 COUNTRY CLUB DR BLDG B 203B
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-4126
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Country | US
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Telephone | 760-674-3847
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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 | 15775
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License Number State | CA
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