Provider Demographics
NPI:1619566304
Name:SMITH, VERONICA (APRN)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5950 BULLARD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-2816
Mailing Address - Country:US
Mailing Address - Phone:504-354-4188
Mailing Address - Fax:504-354-4141
Practice Address - Street 1:5950 BULLARD AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70128-2816
Practice Address - Country:US
Practice Address - Phone:504-354-4188
Practice Address - Fax:504-354-4141
Is Sole Proprietor?:No
Enumeration Date:2021-01-16
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA218052363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily