Provider Demographics
NPI:1063775724
Name:SMITH, BRITT ALISON (NP-C)
Entity type:Individual
Prefix:MRS
First Name:BRITT
Middle Name:ALISON
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:NEEDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77461-8443
Mailing Address - Country:US
Mailing Address - Phone:979-793-4114
Mailing Address - Fax:
Practice Address - Street 1:3006 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:NEEDVILLE
Practice Address - State:TX
Practice Address - Zip Code:77461-8443
Practice Address - Country:US
Practice Address - Phone:979-793-4114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX652728363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX319742801Medicaid
TX8011NAOtherBC/BS #
TX8011NAOtherBC/BS #