Jean A Smith, FNP
Individual provider Active NPI General Practice Registered Nurse · Fordland, MO
NPI 1962474486 · NPPES record last updated Jul 5, 2011
Key facts
- NPI
- 1962474486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Registered Nurse 163WG0000X
- License
- 153384 (MO)
- Practice address
- 1059 Barton Dr
Fordland, MO 65652-7350 - Phone
- (417) 767-2273
- Fax
- (417) 767-4054
- NPI assigned
- Feb 7, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Springfield Family Medical Walk in Clinics Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 153384 | MO | Yes |
Addresses
Primary practice location
1059 Barton Dr
Fordland, MO 65652-7350
Mailing address
1059 Barton Dr
Fordland, MO 65652-7350
Phone (417) 767-2273
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 424622504 | Medicaid | MO |
Other providers in Fordland, MO
- Erin K Rickman
- Evan Rowland
- Brittany Schroeder
- Delana Shoemake
- Taylor Russel Short
- Lydia Thompson
- Ashley C Wilson
- Michelle Young
All providers in Fordland, MO · General Practice Registered Nurse in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 2011. 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.