Provider Demographics
NPI:1619362837
Name:SMITH, EMILY (CRNP)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10110 MOLECULAR DR
Mailing Address - Street 2:STE 206
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-7539
Mailing Address - Country:US
Mailing Address - Phone:301-279-2779
Mailing Address - Fax:301-279-2767
Practice Address - Street 1:10110 MOLECULAR DR
Practice Address - Street 2:STE 206
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-7539
Practice Address - Country:US
Practice Address - Phone:301-279-2779
Practice Address - Fax:301-279-2767
Is Sole Proprietor?:No
Enumeration Date:2015-04-03
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR189956363LA2200X, 363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology