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NPI Code Detail

MEDICARE: TERRY LEE SMITH FNP

MEDICARE: TERRY LEE SMITH FNP
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
1363L00000XNurse Practitioner9360074FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508952292
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRY LEE SMITH FNP
Provider Business Mailing Address
First Line : 6605 HILLWAY CIR
Second Line : STE 101
City : NAPLES
State : FL
Zip : 34112-8754
Country : US
Telephone Number : 239-262-6550
Fax Number :
Provider Business Practice Location Address
First Line : 6605 HILLWAY CIR STE 101
Second Line :
City : NAPLES
State : FL
Zip : 34112-8754
Country : US
Telephone Number : 239-262-6550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 01/30/2025

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