Provider Demographics
NPI:1497115356
Name:SMITH, VICTORIA L (FNP-C)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP-C
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Mailing Address - Street 1:571 SAINT JOSEPHS BLVD
Mailing Address - Street 2:FL 2
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3230
Mailing Address - Country:US
Mailing Address - Phone:607-271-2050
Mailing Address - Fax:
Practice Address - Street 1:100 JOHN ROEMMELT DR STE 101
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-8302
Practice Address - Country:US
Practice Address - Phone:607-739-0352
Practice Address - Fax:607-739-6909
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-03
Last Update Date:2021-09-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY340620363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner