Provider Demographics
NPI:1558466391
Name:SMITH, JOAN HUGHES (MSN NP C)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:HUGHES
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSN NP C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8595 PICANDY AVENUE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3675
Mailing Address - Country:US
Mailing Address - Phone:225-769-4493
Mailing Address - Fax:225-766-3144
Practice Address - Street 1:8595 PICANDY AVENUE
Practice Address - Street 2:SUITE 320
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3675
Practice Address - Country:US
Practice Address - Phone:225-769-4493
Practice Address - Fax:225-766-3144
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN084800AP04745363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1775410Medicaid
LA1775410Medicaid
Q49819Medicare UPIN