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LEANNA MARIE BROOKS SMITH CNP

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1407847726

Individual Registrant:
 LEANNA MARIE BROOKS SMITH CNP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
2900 DOOLITTLE DRIVE  ELLSWORTH AIR FORCE BASE, SD 57760 US
Tel: 605-385-3111  Fax: --

Contact information for business:
2900 DOOLITTLE DRIVE ATTEN MEDICAL STAFF SERVICES ELLSWORTH AIR FORCE BASE, SD 57706 US
Tel: 605-385-3111  Fax: 605-385-3680

Registration Information:
NPI: 1407847726
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
SDCP000344

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
LICENSECP000344SD01




HEALTH CARE JOBS SD - Page 1

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