MEDICARE: ELIZABETH LEE 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
1	363L00000X	Nurse Practitioner	290996	AZ
2	363L00000X	Nurse Practitioner	895119	NV

General Provider Information

NPI Number	:	1326744509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH LEE SMITH

Provider Business Mailing Address
First Line	:	732 S 6TH ST # 7221
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-6948
Country	:	US
Telephone Number	:	775-244-5354
Fax Number	:

Provider Business Practice Location Address
First Line	:	750 S RAMPART BLVD STE 8
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-5808
Country	:	US
Telephone Number	:	725-999-4921
Fax Number	:

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

Provider Enumeration Date	:	01/31/2023
Last Update Date	:	05/22/2026

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