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General NPI Number Information
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NPI Number | 1871160143
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Entity Type | Individual
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Provider Name | MICHAEL P SMITH APRN-CNP
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Gender | Male
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Dates
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Enumeration Date | 06/07/2021
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 1225 N STATE ST
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City | JACKSON
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State | MS
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Zip | 39202-2064
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Country | US
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Telephone | 901-226-4003
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Fax | 901-227-8591
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Provider Business Mailing Address
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Address Line | 350 N HUMPHREYS BLVD
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City | MEMPHIS
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State | TN
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Zip | 38120-2177
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Country | US
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Telephone | 901-226-4003
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Fax | 901-227-8591
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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 | APRN.CNP.0037024
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11012101
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 907809
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License Number State | MS
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