Provider Demographics
NPI:1982248712
Name:DANIEL, M. ELIZABETH SMITH (RN)
Entity Type:Individual
Prefix:
First Name:M. ELIZABETH
Middle Name:SMITH
Last Name:DANIEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MAHALIA
Other - Middle Name:ELIZABETH
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 1368
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85366-2361
Mailing Address - Country:US
Mailing Address - Phone:760-572-4131
Mailing Address - Fax:
Practice Address - Street 1:401 PICACHO RD
Practice Address - Street 2:
Practice Address - City:WINTERHAVEN
Practice Address - State:CA
Practice Address - Zip Code:92283-9605
Practice Address - Country:US
Practice Address - Phone:760-572-4131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2598332163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse