| Doctor Name: | NICOLE SMITH |
| NPI Number: | 1154712776 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | 348429-3102 |
| Business Practice Address: | 133 S 500 E Vernal, UT - 840782728 |
| Business Phone Number: | 4352471196 |
| Business Fax Number: | 4357810536 |
| Mailing Address: | 133 S 500 E, VERNAL |
| State: | UT |
| Postal Code: | 840782728 |
| Phone Number: | 4352471196 |
| Fax Number: | 4357810536 |
| NPI Enumeration Date: | 02/18/2015 |
| NPI Last Update Date: | 02/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | 348429-3102 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |