Provider Demographics
NPI:1669644191
Name:SMITH, MARGARET JAN (RN, MSN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:JAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN, MSN, FNP-C
Other - Prefix:
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Mailing Address - Street 1:128 EMERALD BAY DR
Mailing Address - Street 2:
Mailing Address - City:BULLARD
Mailing Address - State:TX
Mailing Address - Zip Code:75757-9367
Mailing Address - Country:US
Mailing Address - Phone:903-477-2888
Mailing Address - Fax:
Practice Address - Street 1:700 OLYMPIC PLAZA CIR STE 600
Practice Address - Street 2:ETMC ORTHOPEDIC INSTITUTE
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-1954
Practice Address - Country:US
Practice Address - Phone:903-596-3844
Practice Address - Fax:903-596-3843
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF1207131363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF1207131OtherFNP-C LICENSE
TX687363OtherRN LICENSE