Provider Demographics
NPI:1568051076
Name:SMILOVIC, EMILY (RN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SMILOVIC
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 BEECH ST APT 419
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-3256
Mailing Address - Country:US
Mailing Address - Phone:917-589-9239
Mailing Address - Fax:
Practice Address - Street 1:750 BEECH ST APT 419
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-3256
Practice Address - Country:US
Practice Address - Phone:917-589-9239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95209884163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse