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General NPI Number Information
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NPI Number | 1871109017
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Entity Type | Individual
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Provider Name | STEPHANIE SMITH FNP
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Gender | Female
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Dates
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Enumeration Date | 09/22/2020
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 3908 10TH ST SE
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City | PUYALLUP
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State | WA
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Zip | 98374-2188
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Country | US
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Telephone | 253-848-5951
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Fax | 253-845-7073
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Provider Business Mailing Address
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Address Line | 286 S LENZNER AVE
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-5685
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Country | US
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Telephone | 520-452-0388
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Fax | 877-281-8622
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP61132596
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License Number State | WA
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