AMANDA ROSE SMITH (NPI# 1992324834) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992324834 |
| Entity Type | Individual |
| Full Name | AMANDA ROSE SMITH |
| Credential | FNP-C |
| Practice Address |
1167 E Broad St Monticello MS 39654-7682 |
| Mailing Address |
Po Box 490 Mccomb MS 39649-0490 |
| Practice Telephone | 6015871433 |
| Practice Fax Number | 6015871625 |
| Mailing Telephone | 6012492701 |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2020-09-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
903907 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1065 E Broad St, Monticello, MS 396547703 | 6015874051 | |
| 700 Jefferson St S, Monticello, MS 396549580 | 6015872593 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508467010 | Amanda Dawn Smith | Physician Assistant | 1621 Spruce St, Zanesville, OH 43701-2534 | 2020-11-03 |
| 1689281297 | Amanda Joy Smith | Massage Therapist | 4915 Rue Vallee Apt 89, Indianapolis, IN 46227-6660 | 2020-09-28 |
| 1902422033 | Amanda Elaine Smith | Nurse Practitioner | 116 Tracy Miles Rd, Franklin, IN 46131-5547 | 2020-06-24 |
| 1619500519 | Amanda Leigh Smith | Marriage & Family Therapist | 1012 Greta St, El Cajon, CA 92021-3258 | 2020-02-19 |
| 1245861335 | Amanda Monique Leanne Smith | Massage Therapist | 4400 Bayou Blvd Ste 26b, Pensacola, FL 32503-1908 | 2020-01-28 |
| 1811544414 | Amanda Rae Smith | Behavior Technician | 105 Clubhouse Cir Apt 102, Idaho Falls, ID 83401-4328 | 2019-08-20 |
| 1306400072 | Amanda J Smith | Occupational Therapy Assistant | 8811 Sandy Plains Dr, Riverview, FL 33578-8619 | 2019-04-27 |
| 1861056079 | Amanda Lynn Smith | Nurse Practitioner | 3785 E Stampede Dr, Gilbert, AZ 85297-8203 | 2019-04-24 |
| 1164996864 | Amanda Marie Smith | Student in an Organized Health Care Education/Training Program | 527 12th Ave E Apt 203, Seattle, WA 98102-5114 | 2019-01-15 |
| 1245701796 | Amanda Michelle Smith | Dietitian, Registered | 20 Columbia Pl Apt B045, Brooklyn, NY 11201-4591 | 2018-12-10 |
| Street Address |
1167 E BROAD ST |
| City | MONTICELLO |
| State | MS |
| Zip Code | 39654-7682 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245289172 | Southwest Mississippi Regional Medical Center | Clinic/Center | 1167 E Broad St, Monticello, MS 39654-7682 | 2006-05-08 |
| 1528086915 | Patrick Brian Wood | Family Medicine | 1167 E Broad St, Monticello, MS 39654-7682 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013558824 | Downhome Pharmacy, Inc. | Pharmacy | 606 W. Broad St, Monticello, MS 39654 | 2019-10-02 |
| 1700344066 | Southwest Mississippi Regional Medical Center | Surgery | 1065 E Broad St., Monticello, MS 39654 | 2019-03-06 |
| 1457862229 | Susan Nevels | Pharmacist | 1509 Highway 84 West, Monticello, MS 39654 | 2017-10-19 |
| 1326565417 | David Warren Ready | Pharmacist | 1509 Hwy 84 West, Monticello, MS 39654 | 2017-08-29 |
| 1861664575 | James Mikel Griffith II | Physical Therapy Assistant | 314 Main St, Ste C, Monticello, MS 39654 | 2008-04-02 |
| 1811169840 | Southwest Mississippi Planning and Development District | Clinic/Center | 1477 Fe Sellers Highway, Monticello, MS 39654 | 2008-03-31 |
| 1447429089 | Foot and Wound Institute of The South | Clinic/Center | 157 Fe Sellers Highway, Monticello, MS 39654 | 2008-02-28 |
| 1346431566 | Amy Eaton Broome | Physical Therapy Assistant | 314 Main St Ste C, Monticello, MS 39654 | 2007-08-05 |
| 1881804532 | Chris Gilbert Boyd | Dentist | 716 Brookhaven Street, Monticello, MS 39654 | 2007-05-23 |
| 1851463707 | Brantley B. Pace | Family Medicine | 713 Watts St., Monticello, MS 39654 | 2006-11-15 |
| Find all providers in zip 39654 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457968406 | Sojnia Irene Johnson | Nurse Practitioner | 561 Country Oaks Ln, Monticello, KY 42633-5145 | 2020-09-24 |
| 1023622081 | Marty Kyle Ballard Sr. | Nurse Practitioner | 698 Lower Brookhaven Rd, Monticello, MS 39654-9627 | 2020-09-06 |
| 1659918936 | Shelby Mcmickle | Nurse Practitioner | 170 Brixie Rd, Monticello, AR 71655-9096 | 2019-12-05 |
| 1104462712 | Ashley Leanna Huitt | Nurse Practitioner | Drew Memorial Health System, 778 Scogin Drive, Monticello, AR 71655 | 2019-11-19 |
| 1053964965 | Faith Healthcare Inc | Nurse Practitioner | 126 Franklin Drive, Monticello, KY 42633 | 2019-07-19 |
| 1740757145 | Karla Marie Wallace | Nurse Practitioner | 314 Main St Ste B, Monticello, MS 39654-3702 | 2018-10-24 |
| 1770039752 | Jesse Bone | Nurse Practitioner | 766 Hl Ross Drive, Monticello, AR 71655 | 2016-08-30 |
| 1295196137 | Miranda Tompkins | Nurse Practitioner | 1215 N Main St Ste 2, Monticello, KY 42633-2900 | 2016-03-18 |
| 1285065292 | Teresa Conerly | Nurse Practitioner | 430 W Broad St, Monticello, MS 39654-7723 | 2013-12-02 |
| 1487089546 | Doretha Bournes | Nurse Practitioner | 354 Cub Brown Rd, Monticello, MS 39654-7505 | 2013-09-09 |
| Find all providers in MONTICELLO | ||||
| City | MONTICELLO |
| Zip Code | 39654 |
Please comment or provide details below to improve the information on AMANDA ROSE SMITH.
| 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.