| Doctor Name: | AMY PITTLICK SMITH |
| NPI Number: | 1013907096 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 13943 |
| Business Practice Address: | 155 Hwy 50 Stateline, NV - 89449 |
| Business Phone Number: | 7755898900 |
| Business Fax Number: | 7755887110 |
| Mailing Address: | 1111 Emerald Bay Rd, SOUTH LAKE TAHOE |
| State: | CA |
| Postal Code: | 961506207 |
| Phone Number: | 5305435659 |
| Fax Number: | 5305418723 |
| NPI Enumeration Date: | 10/21/2005 |
| NPI Last Update Date: | 09/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 13943 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |