Smith, Jimmy D
Smith, Jimmy D is an individual health care provider with primary practice located at 1001 Willow Creek Rd Ste 2200 , Prescott AZ 86301-1614. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Smith, Jimmy D can be contacted via phone (928) 445-6025.Contact Information
Primary practice address
1001 Willow Creek Rd Ste 2200
Prescott AZ 86301-1614
Phone: (928) 445-6025
Fax: (928) 778-3026
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP2306 | Arizona |
Profile Details
| NPI number | 1629027925 |
|---|---|
| LBN Legal business name | Smith, Jimmy D |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 6th, 2006 |
| Last updated | Nov 14th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629027925 | NPPES |
| Arizona | MEDICAID | 084440 | |
| Arizona | Other | Z142983 |
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