MEDICARE: MS. BARBARA SMITH N.P.

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	363LF0000X	Family Nurse Practitioner	4609	CA

General Provider Information

NPI Number	:	1770677536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA SMITH N.P.

Provider Business Mailing Address
First Line	:	6155 CORNERSTONE CT E
Second Line	:	STE 220
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-4736
Country	:	US
Telephone Number	:	858-458-2992
Fax Number	:	858-362-4027

Provider Business Practice Location Address
First Line	:	6155 CORNERSTONE CT E
Second Line	:	STE 220
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-4736
Country	:	US
Telephone Number	:	858-458-2992
Fax Number	:	858-362-4027

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	02/05/2014

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