Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | LB0000145 | DE |
NPI | 1003881194 |
---|---|
Provider Name | Karen M Smith |
First Address | Newark, DE 19713-8003 |
Second Address | Newark, DE 19713-8003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 01/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P50032 | (02) | DE |