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NPI Code Detail

MEDICARE: MRS. QUANNA FETTER SMITH APRN, FNP, BC

MEDICARE: MRS. QUANNA FETTER SMITH APRN, FNP, BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP04427LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043216385
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. QUANNA FETTER SMITH APRN, FNP, BC
Provider Business Mailing Address
First Line : 5959 S SHERWOOD FOREST BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-6038
Country : US
Telephone Number : 225-765-5727
Fax Number : 225-765-4278
Provider Business Practice Location Address
First Line : 5131 ODONOVAN DR STE 201
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-4791
Country : US
Telephone Number : 225-374-0220
Fax Number : 225-374-0221
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 04/15/2021

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