Provider Demographics
NPI:1982882411
Name:SMITH, AIMEE DENISE (FNP)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:DENISE
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:DENISE
Other - Last Name:LETOURNEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1066 PINTAIL CIR
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-7501
Mailing Address - Country:US
Mailing Address - Phone:916-353-1639
Mailing Address - Fax:
Practice Address - Street 1:1600 CREEKSIDE DR
Practice Address - Street 2:STE 3300
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3444
Practice Address - Country:US
Practice Address - Phone:916-983-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11480363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily