Provider Demographics
NPI:1083803845
Name:SMITH, AVA RUTH (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:AVA
Middle Name:RUTH
Last Name:SMITH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:AVA
Other - Middle Name:RUTH
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1842 HICKMAN RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4443
Mailing Address - Country:US
Mailing Address - Phone:904-725-6300
Mailing Address - Fax:904-725-5447
Practice Address - Street 1:1842 HICKMAN RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4443
Practice Address - Country:US
Practice Address - Phone:904-725-6300
Practice Address - Fax:904-725-5447
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2677182363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner