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NPI Code Detail

MEDICARE: SHELIA R SMITH

MEDICARE: SHELIA R SMITH
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
1163W00000XRegistered NurseR36175AR

General Provider Information

NPI Number : 1184876344
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELIA R SMITH
Provider Business Mailing Address
First Line : 800 MARSHALL ST
Second Line : SLOT 900
City : LITTLE ROCK
State : AR
Zip : 72202-3510
Country : US
Telephone Number : 501-364-3620
Fax Number : 501-364-3994
Provider Business Practice Location Address
First Line : 301 W CALHOUN
Second Line :
City : MAGNOLIA
State : AR
Zip : 71753-3508
Country : US
Telephone Number : 870-234-1597
Fax Number : 870-234-1791
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2008
Last Update Date : 10/21/2008

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Directions to “ SHELIA R SMITH ” Practice Location

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