Evelyn Smith, FNP

Individual provider Active NPI Family Nurse Practitioner · Drew, MS

NPI 1679891964 · NPPES record last updated May 11, 2010

Key facts

NPI
1679891964
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
R547115 (MS)
Practice address
121 S Virgie St
Drew, MS 38737-3334
Phone
(662) 745-2331
NPI assigned
May 11, 2010
Sex
Female
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
R547115MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Julia Street Clinic, Inc. Past Accepting new patients
Community Health Clinic Past Accepting new patients
J and R Chiropractic Inc. Past
since Oct 2, 2011
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R547115 MS Yes

Addresses

Primary practice location

121 S Virgie St
Drew, MS 38737-3334

Mailing address

121 S Virgie St
P.O. Box 304
Drew, MS 38737-3334
Phone (662) 745-2331

Other providers in Drew, MS

All providers in Drew, MS · Family Nurse Practitioner in Mississippi

Sources for this page

Verify at the official NPI Registry.