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)CodeLicenseStatePrimary
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

All providers in Rockville, IN · Family Nurse Practitioner in Indiana

Sources for this page

Verify at the official NPI Registry.