=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891378949
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALIGN HEALTHCARE SERVICES, LLC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/05/2021
-----------------------------------------------------
Last Update Date | 05/05/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 39455 LEGACY LAKE DR
-----------------------------------------------------
City | GONZALES
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70737-6647
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-296-4486
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 39455 LEGACY LAKE DR
-----------------------------------------------------
City | GONZALES
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70737-6647
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-296-4486
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/NURSE PRACTITIONER
-----------------------------------------------------
Name | DR. RICHSHELL MARIE SMITH
-----------------------------------------------------
Credential | DNP, WHNP-BC
-----------------------------------------------------
Telephone | 504-296-4486
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QF0050X
-----------------------------------------------------
Taxonomy Name | Non-Surgical Family Planning Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------