James E Smith, RN

Individual provider Active NPI Registered Nurse · Mescalero, NM

NPI 1720171333 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1720171333
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
76791 (NM)
Practice address
318 Abalone Loop
Mescalero, NM 88340
Phone
(505) 464-4441
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
76791NMMDRegistered Nurse
PN111281OHMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X PN111281 OH
Registered Nurse 163W00000X 76791 NM Yes

Addresses

Primary practice location

318 Abalone Loop
Mescalero, NM 88340

Mailing address

927 Peach Circle
Tularosa, NM 88352
Phone (575) 585-3320

Other providers in Mescalero, NM

All providers in Mescalero, NM · Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.