Provider Demographics
NPI:1700827730
Name:SMITH, DARI LYNN (FNP-ARNP)
Entity Type:Individual
Prefix:MS
First Name:DARI
Middle Name:LYNN
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP-ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 SW 16TH PLACE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601
Mailing Address - Country:US
Mailing Address - Phone:352-548-1101
Mailing Address - Fax:352-548-1139
Practice Address - Street 1:4354 NW 23RD AVENUE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606
Practice Address - Country:US
Practice Address - Phone:352-376-4565
Practice Address - Fax:352-548-1139
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1619382363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL303790800Medicaid
FL303790800Medicaid
FLY9997ZMedicare PIN
P33311Medicare UPIN
FLP33311Medicare UPIN
FLY9997Medicare ID - Type Unspecified