Provider Demographics
NPI:1275405086
Name:SMEDRA, MAGDALENA (APRN)
Entity type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:
Last Name:SMEDRA
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 1:8 WOODLAWN ST
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-4029
Mailing Address - Country:US
Mailing Address - Phone:860-878-0864
Mailing Address - Fax:
Practice Address - Street 1:151 HAZARD AVE STE 9
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-4588
Practice Address - Country:US
Practice Address - Phone:860-749-2251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT15212363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily