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General NPI Number Information
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NPI Number | 1790940294
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Entity Type | Individual
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Provider Name | JAMIE N SMITH MPH, P.A.-C
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Gender | Female
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 05/27/2015
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Provider Practice Location Address
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Address Line | 3414 MOSS ST STE F
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City | LAFAYETTE
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State | LA
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Zip | 70507-6107
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Country | US
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Telephone | 337-706-8986
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Fax | 337-706-8714
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Provider Business Mailing Address
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Address Line | 3414 MOSS ST STE F
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City | LAFAYETTE
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State | LA
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Zip | 70507-6107
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Country | US
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Telephone | 337-706-8986
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Fax | 337-706-8714
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.200224
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License Number State | LA
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