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NPI Code Detail

MEDICARE: MRS. JESSICA LORRAINE SMITH NP

MEDICARE:  MRS. JESSICA LORRAINE SMITH  NP
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
1363LF0000XFamily Nurse Practitioner70905NM

General Provider Information

NPI Number : 1952813487
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JESSICA LORRAINE SMITH NP
Provider Business Mailing Address
First Line : 1833 LAS TUNAS DR
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-4956
Country : US
Telephone Number : 575-571-0755
Fax Number :
Provider Business Practice Location Address
First Line : 905 S 8TH ST STE B
Second Line :
City : DEMING
State : NM
Zip : 88030-4037
Country : US
Telephone Number : 575-543-7200
Fax Number : 575-543-7250
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2017
Last Update Date : 03/17/2023

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Directions to “ MRS. JESSICA LORRAINE SMITH NP” Practice Location

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