Doctor Name: | TAMMY R SMITH |
NPI Number: | 1548254097 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | 56022 |
Business Practice Address: | 410 Main Street Gulf Family Practice Sophia, WV - 259211304 |
Business Phone Number: | 3046834304 |
Business Fax Number: | 3046834307 |
Mailing Address: | Po Box 337, SCARBRO |
State: | WV |
Postal Code: | 259170337 |
Phone Number: | 3044692905 |
Fax Number: | 3044653180 |
NPI Enumeration Date: | 09/09/2005 |
NPI Last Update Date: | 08/12/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 56022 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |