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General NPI Number Information
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NPI Number | 1821059189
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Entity Type | Individual
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Provider Name | CYNTHIA LEE SMITH FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 515 N MESA DR
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City | MESA
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State | AZ
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Zip | 85201-5914
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Country | US
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Telephone | 480-844-6285
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Fax | 480-844-4154
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Provider Business Mailing Address
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Address Line | 1612 W STOTTLER DR
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City | CHANDLER
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State | AZ
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Zip | 85224-2663
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Country | US
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Telephone | 480-963-9417
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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 | RN055481
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License Number State | AZ
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