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General NPI Number Information
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NPI Number | 1942571328
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Entity Type | Individual
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Provider Name | ANDREA MARIE SMITH ACNP
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Gender | Female
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Dates
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Enumeration Date | 01/18/2012
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Last Update Date | 01/18/2012
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Provider Practice Location Address
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Address Line | 4500 S LANCASTER RD
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City | DALLAS
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State | TX
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Zip | 75216-7167
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Country | US
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Telephone | 870-672-3275
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Fax |
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Provider Business Mailing Address
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Address Line | 1002 ASTER DR
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72117-9761
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Country | US
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Telephone | 870-672-3275
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | A03497 ANP
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License Number State | AR
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