Larry Edwin Smith, FNP
Individual provider Active NPI Family Nurse Practitioner · Rockville, IN
NPI 1659979268 · NPPES record last updated Oct 15, 2020
Key facts
- NPI
- 1659979268
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71010467A (IN)
- Practice address
- 768 N US Highway 41
Rockville, IN 47872-7091 - Phone
- (812) 360-0047
- NPI assigned
- Oct 15, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71010467A | IN | Yes |
Addresses
Primary practice location
768 N US Highway 41
Rockville, IN 47872-7091
Mailing address
3155 W 57TH St
Indianapolis, IN 46228-1609
Phone (812) 360-0047
Other providers in Rockville, IN
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- Donna Gayle Smith
- Rebecca Smith
- Amber Stinson
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- The Narrow Gate LLC
- Thomas D Nicholas MD Daniel J Dwyer MD
All providers in Rockville, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.