MEDICARE: MRS. LILLIAN SMILEY RN

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	163WP1700X	Perinatal Registered Nurse	274149	CA

General Provider Information

NPI Number	:	1851431860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LILLIAN SMILEY RN

Provider Business Mailing Address
First Line	:	PO BOX 402127
Second Line	:
City	:	HESPERIA
State	:	CA
Zip	:	92340-2127
Country	:	US
Telephone Number	:	760-956-6780
Fax Number	:	760-956-3761

Provider Business Practice Location Address
First Line	:	11951 HESPERIA RD
Second Line	:
City	:	HESPERIA
State	:	CA
Zip	:	92345-1855
Country	:	US
Telephone Number	:	760-956-6780
Fax Number	:	760-956-3761

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

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	07/08/2007

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