Doctor Name: | HARRIETT WILLIEMAE SMITH-MCKINNEY |
NPI Number: | 1275597320 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA 2621 |
Business Practice Address: | 10762 Se Us Highway 441 Belleview, FL - 344203805 |
Business Phone Number: | 3523475225 |
Business Fax Number: | 3523471073 |
Mailing Address: | 2500 Citrus Blvd, LEESBURG |
State: | FL |
Postal Code: | 347483063 |
Phone Number: | 3523475225 |
Fax Number: | 3523471073 |
NPI Enumeration Date: | 04/14/2006 |
NPI Last Update Date: | 11/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA 2621 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |