Provider Demographics
NPI:1760046452
Name:SMITH, DANNYEL (MSN-AGNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DANNYEL
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSN-AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W HEFNER RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-6631
Mailing Address - Country:US
Mailing Address - Phone:405-896-8058
Mailing Address - Fax:
Practice Address - Street 1:101 W HEFNER RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-6631
Practice Address - Country:US
Practice Address - Phone:405-896-8058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-28
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN245082363L00000X
OK202274363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK202274OtherAPRN LICENSE
GARN245082OtherGEORGIA RN LICENSE