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1326721796
SHANE RAY SMITH
PEORIA, AZ
NPI
1326721796
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: AZ 300208)
Enumeration Date
2023-08-10
Last Update Date
2023-11-15
Business Address
SHANE RAY SMITH FNP-C
10230 W HAPPY VALLEY PKWY
PEORIA, AZ 85383-4691
Phone number: 623-561-3030
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Mailing Address
SHANE RAY SMITH FNP-C
21735 N 119TH DR
SUN CITY, AZ 85373-5650
Phone number: 623-628-1522
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