| NPI | 1275099723 |
|---|---|
| Former Name | CALLIE JEAN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2260921) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 061024-23) |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2023-01-11 |