Provider Demographics
NPI:1922629138
Name:SMITH, STORMY DAWN (ARNP)
Entity type:Individual
Prefix:
First Name:STORMY
Middle Name:DAWN
Last Name:SMITH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:
Mailing Address - City:CROWELL
Mailing Address - State:TX
Mailing Address - Zip Code:79227-0355
Mailing Address - Country:US
Mailing Address - Phone:940-684-1515
Mailing Address - Fax:940-684-1953
Practice Address - Street 1:PO BOX 355
Practice Address - Street 2:
Practice Address - City:CROWELL
Practice Address - State:TX
Practice Address - Zip Code:79227-0355
Practice Address - Country:US
Practice Address - Phone:940-684-1515
Practice Address - Fax:940-684-1953
Is Sole Proprietor?:No
Enumeration Date:2020-04-28
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1056759363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily