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NPI Code Detail

MEDICARE: STEPHANIE SMILO AGACNP-BC

MEDICARE:   STEPHANIE  SMILO  AGACNP-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
1363LA2100XAcute Care Nurse PractitionerAP132471TX
2363LG0600XGerontology Nurse PractitionerAP132471TX

General Provider Information

NPI Number : 1356893606
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE SMILO AGACNP-BC
Provider Business Mailing Address
First Line : 6540 ISLA DEL REY DR
Second Line :
City : EL PASO
State : TX
Zip : 79912-7340
Country : US
Telephone Number : 734-558-9688
Fax Number :
Provider Business Practice Location Address
First Line : 6540 ISLA DEL REY DR
Second Line :
City : EL PASO
State : TX
Zip : 79912-7340
Country : US
Telephone Number : 734-558-9688
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2016
Last Update Date : 11/02/2016

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Directions to “ STEPHANIE SMILO AGACNP-BC” Practice Location

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