Provider Demographics
NPI:1134935554
Name:SMITH, JOZETTE DEANNA (RN)
Entity type:Individual
Prefix:
First Name:JOZETTE
Middle Name:DEANNA
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 WHITE PINE CIR APT 300
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-8487
Mailing Address - Country:US
Mailing Address - Phone:703-877-0414
Mailing Address - Fax:
Practice Address - Street 1:1690 OLD BRIDGE RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-8006
Practice Address - Country:US
Practice Address - Phone:202-487-0701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001333296163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse