Doctor Name: | JILLIANN MARIE SMITH |
NPI Number: | 1023306651 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | 336881 |
Business Practice Address: | 831 Maple Rd Williamsville, NY - 142213267 |
Business Phone Number: | 7165651978 |
Business Fax Number: | 7165651983 |
Mailing Address: | 238 Ashwood Ln, ORCHARD PARK |
State: | NY |
Postal Code: | 141274852 |
Phone Number: | 7164087554 |
Fax Number: | |
NPI Enumeration Date: | 07/18/2011 |
NPI Last Update Date: | 09/30/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 336881 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |