Doctor Name: | JOANNE CHAROLETTE SMILEY |
NPI Number: | 1649227901 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 79293 |
Business Practice Address: | 4491 Bent Bros Blvd Colorado City, CO - 81019 |
Business Phone Number: | 7196762273 |
Business Fax Number: | |
Mailing Address: | 4491 Bent Bros Blvd, COLORADO CITY |
State: | CO |
Postal Code: | 81019 |
Phone Number: | 7196762273 |
Fax Number: | |
NPI Enumeration Date: | 05/30/2006 |
NPI Last Update Date: | 03/26/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 79293 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |