| NPI | 1851483101 |
|---|---|
| Former Name | FAYE ELLEN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 080187) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45967) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2009-03-05 |