MEDICARE: LORI L. SMITH-WILLIAMSON MSN, N.P.

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
1	2084P0800X	Psychiatry Physician	R220623	MD

General Provider Information

NPI Number	:	1134160328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI L. SMITH-WILLIAMSON MSN, N.P.

Provider Business Mailing Address
First Line	:	975 SOLOMONS ISLAND RD N
Second Line	:
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678-3917
Country	:	US
Telephone Number	:	410-535-5400
Fax Number	:	410-414-9413

Provider Business Practice Location Address
First Line	:	975 SOLOMONS ISLAND RD N
Second Line	:
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678-3917
Country	:	US
Telephone Number	:	410-535-5400
Fax Number	:	410-414-9413

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	07/14/2016

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