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NPI Code Detail

MEDICARE: MRS. GEMMA N SMITH NP-C

MEDICARE: MRS. GEMMA N SMITH NP-C
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
1363L00000XNurse Practitioner1248AK
2363LF0000XFamily Nurse Practitioner1248AK

General Provider Information

NPI Number : 1053691055
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GEMMA N SMITH NP-C
Provider Business Mailing Address
First Line : PO BOX 240
Second Line :
City : KENAI
State : AK
Zip : 99611-0240
Country : US
Telephone Number : 907-283-9118
Fax Number : 907-283-5341
Provider Business Practice Location Address
First Line : 10543 KENAI SPUR HWY
Second Line :
City : KENAI
State : AK
Zip : 99611-7812
Country : US
Telephone Number : 907-283-9118
Fax Number : 907-283-5341
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2011
Last Update Date : 08/22/2011

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Directions to “ MRS. GEMMA N SMITH NP-C” Practice Location

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