Provider Demographics
NPI:1912123746
Name:SMITH, MARGARET B (CNP)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:B
Last Name:SMITH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 6TH AVENUE SOUTH
Mailing Address - Street 2:
Mailing Address - City:BRIMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233
Mailing Address - Country:US
Mailing Address - Phone:205-930-1135
Mailing Address - Fax:205-930-1326
Practice Address - Street 1:631 BESSEMER SUPER HWY
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35228
Practice Address - Country:US
Practice Address - Phone:205-930-1135
Practice Address - Fax:205-930-1326
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-054250363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL227340000Medicaid
AL511-14689OtherBLUE CROSS BLUE SHIELD OF AL. (BESSEMER LOCATION)