| Doctor Name: | LORA MICHELLE SMITH |
| NPI Number: | 1225323090 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | R88-2467 |
| Business Practice Address: | 9075 Sandidge Center Cv Olive Branch, MS - 386543514 |
| Business Phone Number: | 6628954949 |
| Business Fax Number: | 6628956776 |
| Mailing Address: | 9075 Sandidge Center Cv, OLIVE BRANCH |
| State: | MS |
| Postal Code: | 386543514 |
| Phone Number: | 6628954949 |
| Fax Number: | 6628956776 |
| NPI Enumeration Date: | 06/09/2011 |
| NPI Last Update Date: | 01/29/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R88-2467 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |