| Doctor Name: | TATIANA G SMIRNOVA |
| NPI Number: | 1083685689 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | R168730 |
| Business Practice Address: | 25 Crossroads Dr Suite 205 Owings Mills, MD - 211175421 |
| Business Phone Number: | 4106027792 |
| Business Fax Number: | 4106029889 |
| Mailing Address: | 1589 Sulphur Spring Rd, Suite 109 BALTIMORE |
| State: | MD |
| Postal Code: | 212272542 |
| Phone Number: | 4105365400 |
| Fax Number: | 4107372168 |
| NPI Enumeration Date: | 01/31/2006 |
| NPI Last Update Date: | 09/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | R168730 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |