Provider Demographics
NPI:1033709209
Name:SMITH, TAWNY BEE (RN)
Entity Type:Individual
Prefix:
First Name:TAWNY
Middle Name:BEE
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6546 EVESHAM CIR
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-4909
Mailing Address - Country:US
Mailing Address - Phone:831-210-8851
Mailing Address - Fax:
Practice Address - Street 1:6546 EVESHAM CIR
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-4909
Practice Address - Country:US
Practice Address - Phone:831-210-8851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA494418163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse