Provider Demographics
NPI:1306160635
Name:SMITH, FELICITY JANET (CDM)
Entity type:Individual
Prefix:MRS
First Name:FELICITY
Middle Name:JANET
Last Name:SMITH
Suffix:
Gender:F
Credentials:CDM
Other - Prefix:MISS
Other - First Name:FELICITY
Other - Middle Name:JANET
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3730 RHONE CIR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5054
Mailing Address - Country:US
Mailing Address - Phone:907-561-5152
Mailing Address - Fax:907-562-2585
Practice Address - Street 1:3730 RHONE CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5054
Practice Address - Country:US
Practice Address - Phone:907-561-5152
Practice Address - Fax:907-562-2585
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK60176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife