Provider Demographics
NPI:1619947884
Name:SMITH, DEIRDRE O'REILLY (RN, ANP-C)
Entity Type:Individual
Prefix:MRS
First Name:DEIRDRE
Middle Name:O'REILLY
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN, ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:8802 BLUEBIRD TRCE
Mailing Address - Street 2:
Mailing Address - City:SCAGGSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1294
Mailing Address - Country:US
Mailing Address - Phone:301-725-7220
Mailing Address - Fax:
Practice Address - Street 1:2480 LLEWELLYN AVE
Practice Address - Street 2:
Practice Address - City:FT MEADE
Practice Address - State:MD
Practice Address - Zip Code:20755-5800
Practice Address - Country:US
Practice Address - Phone:301-677-8333
Practice Address - Fax:301-677-8399
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR083055363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health