Doctor Name: | SAMMI R SMITH |
NPI Number: | 1013982693 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | AP04110 |
Business Practice Address: | 2727 Hearne Ave Shreveport, LA - 711033931 |
Business Phone Number: | 3186316400 |
Business Fax Number: | 3186310300 |
Mailing Address: | 2449 Hospital Dr., Suite 400 BOSSIER CITY |
State: | LA |
Postal Code: | 711111914 |
Phone Number: | 3152127902 |
Fax Number: | 3182127905 |
NPI Enumeration Date: | 02/17/2006 |
NPI Last Update Date: | 07/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2100X |
License Number: | AP04110 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |