Provider Demographics
NPI:1720780414
Name:SMITH, ESTEFANNIE KAMILA (HWNC-BC, RN, BSN)
Entity Type:Individual
Prefix:
First Name:ESTEFANNIE
Middle Name:KAMILA
Last Name:SMITH
Suffix:
Gender:F
Credentials:HWNC-BC, RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 STURDIES BAY ROAD
Mailing Address - Street 2:
Mailing Address - City:GALIANO ISLAND
Mailing Address - State:BRITISH COLOMBIA
Mailing Address - Zip Code:V0N 1P0
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1141 STURDIES BAY ROAD
Practice Address - Street 2:
Practice Address - City:GALIANO ISLAND
Practice Address - State:BRITISH COLOMBIA
Practice Address - Zip Code:V0N 1P0
Practice Address - Country:CA
Practice Address - Phone:604-836-8169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95107800171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach