ALISA DIANA SMITH FNP NPI 1740421767

NPI Information

NPI: 1740421767
Provider Name: ALISA DIANA SMITH, FNP
Classification: Registered Nurse - 163WG0000X
Entity Type: Individual

Specialization: General Practice

PECOS Registration: Yes

Address:
3990 JOHN R ST
4838
DETROIT, MI
ZIP 48201
Phone: (313) 618-9294
Get Directions

Alisa Diana Smith, FNP is a general practice registered nurse in Detroit, MI. Alisa Diana Smith, FNP NPI is 1740421767. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3990 JOHN R ST
4838
DETROIT, MI
ZIP 48201-018
Phone: (313) 618-9294

The NPI 1740421767 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/20/2009 and was last updated on 3/20/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WG0000X	Registered Nurse	General Practice	4704136416	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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