Provider Demographics
NPI:1104342682
Name:SMITH, ANIECE NICOLE (FNP-C)
Entity type:Individual
Prefix:
First Name:ANIECE
Middle Name:NICOLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 POYDRAS ST STE 900
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-1282
Mailing Address - Country:US
Mailing Address - Phone:504-648-6767
Mailing Address - Fax:504-399-5663
Practice Address - Street 1:1615 POYDRAS ST STE 900
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-1282
Practice Address - Country:US
Practice Address - Phone:504-648-6767
Practice Address - Fax:504-399-5663
Is Sole Proprietor?:No
Enumeration Date:2017-08-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09448363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily