Basic Information
Provider Information
NPI: 1215456124
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SMITH
FirstName: EMILY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: WHNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 151
Address2:  
City: NEW CASTLE
State: DE
PostalCode: 197200151
CountryCode: US
TelephoneNumber: 3026522455
FaxNumber: 3023226251
Practice Location
Address1: 1802 W 4TH ST
Address2:  
City: WILMINGTON
State: DE
PostalCode: 198053420
CountryCode: US
TelephoneNumber: 3026522455
FaxNumber: 3023226251
Other Information
ProviderEnumerationDate: 09/12/2017
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LX0001XLH-0000225DEN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
363LW0102XLH0000225DEY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health

No ID Information.


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