Provider Demographics
NPI:1386736205
Name:SMITH, JANET L (CFNP)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1691 GALISTEO ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4780
Mailing Address - Country:US
Mailing Address - Phone:505-983-5631
Mailing Address - Fax:505-982-5605
Practice Address - Street 1:1691 GALISTEO ST
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4780
Practice Address - Country:US
Practice Address - Phone:505-983-5631
Practice Address - Fax:505-982-5605
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2013-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMR36862363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner