Provider Demographics
NPI:1982986444
Name:SMITH, NORSHAWNDRA MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NORSHAWNDRA
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 STATE ROAD 60 E
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33853-4329
Mailing Address - Country:US
Mailing Address - Phone:863-676-9496
Mailing Address - Fax:863-678-1829
Practice Address - Street 1:1903 STATE ROAD 60 E
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853-4329
Practice Address - Country:US
Practice Address - Phone:863-676-9496
Practice Address - Fax:863-678-1829
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47843183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist