Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 0024178190 | VA |
NPI | 1033751383 |
---|---|
Provider Name | Ms. Hannah B Smith |
First Address | Roanoke, VA 24016-4418 |
Second Address | Roanoke, VA 24016-4418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2019 |
Last Update Date | 29/07/2021 |