Provider Demographics
NPI:1043522824
Name:SMITH, JAMES E JR (FNP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9500 E. IRONWOOD SQUARE DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258
Mailing Address - Country:US
Mailing Address - Phone:480-664-8988
Mailing Address - Fax:480-664-8998
Practice Address - Street 1:9500 E. IRONWOOD SQUARE DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258
Practice Address - Country:US
Practice Address - Phone:480-664-8988
Practice Address - Fax:480-664-8998
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3609363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily