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General NPI Number Information
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NPI Number | 1912704198
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Entity Type | Individual
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Provider Name | WENDY SMITH
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Gender | Female
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 831 HIGHWAY 463 N
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City | TRUMANN
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State | AR
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Zip | 72472-1636
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Country | US
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Telephone | 870-418-0794
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Fax |
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Provider Business Mailing Address
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Address Line | 831 HIGHWAY 463 N
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City | TRUMANN
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State | AR
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Zip | 72472-1636
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Country | US
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Telephone |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | L035108
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License Number State | AR
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