Most Relevant Information
Provider Data
| NPI Number: | 1003055005 |
| Provider Name: | STEPHANIE D. SMITH CFNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | R865285 |
Most Important Dates
| Enumeration Date: | 02/13/2009 |
| Last Updated: | 02/13/2009 |
Provider Practice Location
1101 HWY 11 S
ELLISVILLE
MS
394374443
Practice Location Phone/Fax
| Phone: | 6014775770 |
| Fax: |
Provider Mailing Location
57 WATERTANK RD
LAUREL
MS
394432954
Provider Mailing Phone/Fax
| Phone: | 6015771000 |
| Fax: |