| Doctor Name: | JESSICA SMITH |
| NPI Number: | 1093072415 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN, NP-C |
| License Number: | 050915-23 |
| Business Practice Address: | 4 Birch St Derry, NH - 030382136 |
| Business Phone Number: | 6034341354 |
| Business Fax Number: | |
| Mailing Address: | 128 Lakeside Ave, Suite 301 BURLINGTON |
| State: | VT |
| Postal Code: | 054014939 |
| Phone Number: | 8024489719 |
| Fax Number: | |
| NPI Enumeration Date: | 04/23/2012 |
| NPI Last Update Date: | 02/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 050915-23 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |