JENNA RAE SMITH

FORT WAYNE, IN
NPI1720838816
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IN  71015347A)
Additional Taxonomies163WU0100X Registered Nurse, Urology
(Licence: IN  28209700A)
Enumeration Date2024-03-25
Last Update Date2024-09-03
Business Address
JENNA RAE SMITH
11141 PARKVIEW PLAZA DR STE 320
FORT WAYNE, IN 46845-1714
Phone number: 260-425-5400
Mailing Address
JENNA RAE SMITH
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number: