Leeza Caroline Smith, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2023050148 Issued in MO

Practice address

1648 W Harper St Ste 2
Poplar Bluff, MO 63901-4110

Phone

(573) 609-2203

NPI assigned

Feb 5, 2024

Last updated

Feb 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1386407187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14458 SPYGLASS PT",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638418334",
            "telephone_number": "573-300-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 W HARPER ST STE 2",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014110",
            "telephone_number": "573-609-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LEEZA",
        "middle_name": "CAROLINE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2023050148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisabeth Suzanne Smith
• Emryn Lynnette Smith
• Gilbert D Smith, M.D.
• Kennth Allen Smith
• Kila Champaign Smith
• Lori Smith
• Mark Gerard Smith, DPT
• Oscar Brian Smith I, RRT
• Rachel Jean Smith, NP
• Robert Porter Smith, M.D.

• Family Nurse Practitioner in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.