Provider Demographics
NPI:1427045491
Name:HOWELL SMITH, KORI ANN (APRN)
Entity Type:Individual
Prefix:
First Name:KORI
Middle Name:ANN
Last Name:HOWELL SMITH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KORI
Other - Middle Name:
Other - Last Name:HOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-9888
Mailing Address - Fax:239-343-9868
Practice Address - Street 1:4751 S CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907
Practice Address - Country:US
Practice Address - Phone:239-343-9888
Practice Address - Fax:239-343-9868
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9206243363L00000X, 363LF0000X
FLAPRN9206243363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306882000Medicaid