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NPI Code Detail

MEDICARE: MRS. ANGELA ROSE SMITH NP-C

MEDICARE:  MRS. ANGELA ROSE 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
1363LF0000XFamily Nurse Practitioner216273AR

General Provider Information

NPI Number : 1396313615
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANGELA ROSE SMITH NP-C
Provider Business Mailing Address
First Line : 5901 ROCK SPRINGS RD
Second Line :
City : HARRISON
State : AR
Zip : 72601-9773
Country : US
Telephone Number : 870-577-3896
Fax Number :
Provider Business Practice Location Address
First Line : 5901 ROCK SPRINGS RD
Second Line :
City : HARRISON
State : AR
Zip : 72601-9773
Country : US
Telephone Number : 870-577-3896
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2021
Last Update Date : 06/17/2021

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Directions to “ MRS. ANGELA ROSE SMITH NP-C” Practice Location

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