Provider Demographics
NPI:1477668648
Name:DOGLIO SMITH, JOAN M (CNM)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:DOGLIO SMITH
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4204 CLIFFWOOD CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-7307
Mailing Address - Country:US
Mailing Address - Phone:512-968-0749
Mailing Address - Fax:
Practice Address - Street 1:4204 CLIFFWOOD CV
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-7307
Practice Address - Country:US
Practice Address - Phone:512-968-0749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX634639163W00000X
TXAP107537367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8004OtherNURSE MIDWIFE
TX634639OtherNURSE MIDWIFE