MEDICARE: NICOLE 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	225700000X	Massage Therapist	7936	LA

General Provider Information

NPI Number	:	1477929735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE SMITH

Provider Business Mailing Address
First Line	:	3920 BARONNE ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-5313
Country	:	US
Telephone Number	:	504-914-9183
Fax Number	:

Provider Business Practice Location Address
First Line	:	3920 BARONNE ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-5313
Country	:	US
Telephone Number	:	504-914-9183
Fax Number	:

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

Provider Enumeration Date	:	08/20/2015
Last Update Date	:	12/19/2025

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Directions to “ NICOLE SMITH ” Practice Location

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