TERESA DIANE SMOOT (NPI# 1215433941) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215433941 |
| Entity Type | Individual |
| Full Name | TERESA DIANE SMOOT |
| Practice Address |
2403 Russell Long Blvd Canyon TX 79016-0005 |
| Practice Telephone | 8066514100 |
| Mailing Telephone | 8066514100 |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2018-04-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP137113 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2403 RUSSELL LONG BLVD |
| City | CANYON |
| State | TX |
| Zip Code | 79016-0005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912920844 | Candy C Marshall | Nurse Practitioner | 2620 Russell Long Blvd, Canyon, TX 79016 | 2006-07-25 |
| 1811400666 | Tracey Dianne Ecklund | Student in an Organized Health Care Education/Training Program | 2620 Russel Long Blvd, Canyon, TX 79016-0001 | 2017-11-14 |
| 1689014326 | Lorna Strong | Specialist/Technologist | 2342 Russell Long Blvd, Virgil Henson Activities Center 217, Canyon, TX 79016-0001 | 2013-06-26 |
| 1235387184 | Traci B Fredman | Speech-Language Pathologist | 2501 4th Ave, Canyon, TX 79016-0001 | 2008-09-04 |
| 1790971224 | Sally Lynn Gaines | Student in an Organized Health Care Education/Training Program | West Texas A & M University, Old Main, Room 308-a, Canyon, TX 79016-0001 | 2007-09-19 |
| 1639394984 | Robby Douglas Rhodes | Specialist/Technologist | 60216 Wtamu, Canyon, TX 79016-0001 | 2007-04-13 |
| 1992869929 | James Edward Gibbs | Family Medicine | Student Medical Services, 2620 Russell Long Blvd., Canyon, TX 79016-0001 | 2006-12-21 |
| 1407967599 | West Texas A&m University Student Medical Services | Clinic/Center | 2620 N Russel Long Blvd, Virgil Henson Activities Center Room 104, Canyon, TX 79016-0001 | 2006-08-31 |
| 1245341692 | Wendy L Bertram | Nurse Practitioner | 2620 N. Russell Long Blvd, Canyon, TX 79016-0001 | 2006-08-31 |
| 1376526129 | Karen Elizabeth Knapp | Nurse Practitioner | Wt Box 61401, Canyon, TX 79016-0001 | 2005-11-25 |
| Find all providers in zip 79016 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104431238 | Candice Martin Taylor | Nurse Practitioner | 4 Neely Ln, Canyon, TX 79015-6470 | 2020-09-15 |
| 1730454240 | Stephanie Suzanne Macklin | Nurse Practitioner | 1101 4th Ave, Canyon, TX 79015-3701 | 2012-03-16 |
| 1245460625 | Gloria Lewis | Nurse Practitioner | 1619 4th Ave, Canyon, TX 79015 | 2009-07-21 |
| 1245341692 | Wendy L Bertram | Nurse Practitioner | 2620 N. Russell Long Blvd, Canyon, TX 79016-0001 | 2006-08-31 |
| 1376526129 | Karen Elizabeth Knapp | Nurse Practitioner | Wt Box 61401, Canyon, TX 79016-0001 | 2005-11-25 |
| 1043820830 | James Rosson | Nurse Practitioner | 1619 4th Ave, Canyon, TX 79015-3824 | 2020-08-05 |
| 1689283293 | April Oliver | Nurse Practitioner | 911 23rd St, Canyon, TX 79015-4645 | 2020-07-29 |
| 1962010892 | Sarah Elizabeth Carlisle | Nurse Practitioner | 1619 4th Ave, Canyon, TX 79015-3824 | 2020-07-16 |
| 1710534607 | Kaitlyn Wynne | Nurse Practitioner | 301 N 23rd St Ste C, Canyon, TX 79015-3058 | 2019-08-25 |
| 1467964148 | Jennifer Susan Turner | Nurse Practitioner | 911 23rd St, Canyon, TX 79015-4645 | 2017-11-02 |
| Find all providers in CANYON | ||||
Please comment or provide details below to improve the information on TERESA DIANE SMOOT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.