Provider Demographics
NPI:1417999319
Name:SMITH, JULIE ELMORE (CRNI)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ELMORE
Last Name:SMITH
Suffix:
Gender:F
Credentials:CRNI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 142
Mailing Address - Street 2:
Mailing Address - City:AXIS
Mailing Address - State:AL
Mailing Address - Zip Code:36505-0142
Mailing Address - Country:US
Mailing Address - Phone:251-675-3228
Mailing Address - Fax:251-675-4209
Practice Address - Street 1:11416 OLD HIGHWAY 43
Practice Address - Street 2:
Practice Address - City:AXIS
Practice Address - State:AL
Practice Address - Zip Code:36505-4646
Practice Address - Country:US
Practice Address - Phone:251-675-3228
Practice Address - Fax:251-675-4209
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-047011163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy