Smith, Sandra L

Smith, Sandra L is an individual health care provider with primary practice located at 4348 Southpoint Blvd Ste 100 , Jacksonville FL 32216-0903. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Smith, Sandra L can be contacted via phone (904) 281-1915.

Contact Information

Primary practice address
4348 Southpoint Blvd Ste 100 Jacksonville FL 32216-0903
Phone: (904) 281-1915
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN.CNP.08269 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X COA.08269-NP Ohio
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X COA.08269-NP Ohio
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X ARNP9477015 Florida
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP9477015 Florida

Profile Details

NPI number 1356342984
LBN Legal business name Smith, Sandra L
Credentials APRN, FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2005
Last updated Oct 6th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356342984 NPPES
Florida MEDICAID 024558600
Florida MEDICAID 2576636

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