Provider Demographics
NPI:1932758042
Name:SMITH, ELIZABETH KAY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KAY
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3335 GLENHILL DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8704
Mailing Address - Country:US
Mailing Address - Phone:361-945-9134
Mailing Address - Fax:
Practice Address - Street 1:2000 GARTH RD STE 1
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-2425
Practice Address - Country:US
Practice Address - Phone:713-461-2915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX802160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily