Doctor Name: | MS. SARA SMOLLER |
NPI Number: | 1306031174 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 267887 |
Business Practice Address: | 250 Paradise Rd Swampscott, MA - 019072948 |
Business Phone Number: | 7815962000 |
Business Fax Number: | |
Mailing Address: | 250 Paradise Rd, SWAMPSCOTT |
State: | MA |
Postal Code: | 019072948 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/13/2007 |
NPI Last Update Date: | 09/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 267887 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |