Provider Demographics
NPI:1821302811
Name:SMITH, LORI HARWOOD (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:HARWOOD
Last Name:SMITH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:GRAHAM
Other - Last Name:HARWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:8383 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-6039
Mailing Address - Country:US
Mailing Address - Phone:850-494-6098
Mailing Address - Fax:850-494-5150
Practice Address - Street 1:8383 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-6039
Practice Address - Country:US
Practice Address - Phone:850-494-6098
Practice Address - Fax:850-494-5150
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9322402367500000X
TN15144367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered