Smith, Theresa M
Smith, Theresa M is an individual health care provider with primary practice located at 1522 17Th St , Lewiston ID 83501-3652. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Smith, Theresa M can be contacted via phone (208) 743-8416.Contact Information
Primary practice address
1522 17Th St
Lewiston ID 83501-3652
Phone: (208) 743-8416
Fax: (208) 743-4642
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | NP388A | Idaho |
Profile Details
| NPI number | 1740331842 |
|---|---|
| LBN Legal business name | Smith, Theresa M |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 15th, 2007 |
| Last updated | Aug 18th, 2021 - about 3 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 | 1740331842 | NPPES |
| Idaho | MEDICAID | 805306500 |
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