Provider Demographics
NPI:1457630774
Name:SMITH, SHELLY R (NP)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:R
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:NIH BUILDING 10 ROOM 3N 210
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:301-451-4374
Mailing Address - Fax:301-480-0145
Practice Address - Street 1:9000 ROCKVILLE PIKE NIH BLDG 10 RM 3N 210
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-451-4374
Practice Address - Fax:301-480-0145
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2023-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024169424363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner