Provider Demographics
NPI:1164504106
Name:SMYTH, PATRICIA EMILY (FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:EMILY
Last Name:SMYTH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 COLLEGE ST MUW-330
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39701-5800
Mailing Address - Country:US
Mailing Address - Phone:662-329-7289
Mailing Address - Fax:662-241-7486
Practice Address - Street 1:1100 COLLEGE ST # MUW-330
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39701-5800
Practice Address - Country:US
Practice Address - Phone:662-329-7289
Practice Address - Fax:662-241-7486
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR82338662363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily