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NPI Code Detail

MEDICARE: RYLEIGH REBECCA YOUNG SMITH CPNP

MEDICARE: RYLEIGH REBECCA YOUNG SMITH CPNP
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 PractitionerAP122068TX
2363LP2300XPrimary Care Nurse PractitionerAP122068TX

General Provider Information

NPI Number : 1861783946
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYLEIGH REBECCA YOUNG SMITH CPNP
Provider Business Mailing Address
First Line : PO BOX 733784
Second Line :
City : DALLAS
State : TX
Zip : 75373-3784
Country : US
Telephone Number : 682-885-1855
Fax Number : 682-885-1396
Provider Business Practice Location Address
First Line : 837 S FLEISHEL AVE
Second Line :
City : TYLER
State : TX
Zip : 75701-2017
Country : US
Telephone Number : 903-526-0450
Fax Number : 903-526-0435
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2011
Last Update Date : 12/20/2022

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Directions to “ RYLEIGH REBECCA YOUNG SMITH CPNP” Practice Location

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