Provider Demographics
NPI:1699730879
Name:SMITH, VERNA M (ARNP)
Entity type:Individual
Prefix:
First Name:VERNA
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:4623 FOREST HILL BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-7469
Mailing Address - Country:US
Mailing Address - Phone:561-967-8888
Mailing Address - Fax:561-641-8303
Practice Address - Street 1:8200 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2003
Practice Address - Country:US
Practice Address - Phone:561-964-1111
Practice Address - Fax:561-967-3144
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2010-12-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP2010652363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307217700Medicaid