Provider Demographics
NPI:1780855593
Name:SMITH, LAURIE A (APRN)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:A
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 1:6630 S MCCARRAN BLVD STE B18
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6136
Mailing Address - Country:US
Mailing Address - Phone:775-237-2833
Mailing Address - Fax:775-237-2823
Practice Address - Street 1:6630 S MCCARRAN BLVD STE B18
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6136
Practice Address - Country:US
Practice Address - Phone:775-237-2833
Practice Address - Fax:775-237-2823
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN00177363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVAPN177OtherAPN NUMBER
NVRN13921OtherRN NUMBER