Chadwycke Richard Smith, NP, AGACNP-BC
Nurse Practitioner, Acute Care in Los Angeles, CA. Individual provider (NPI-1).
NPI number1902387293
StatusActive
Last updated in NPPESSep 4, 2024
Details
- NPI
- 1902387293
- Entity type
- Individual (NPI-1)
- Name
- Mr. Chadwycke Richard Smith
- Credential
- NP, AGACNP-BC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 24, 2018
- Certification date
- Sep 4, 2024
- Last updated
- Sep 4, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2100X | Nurse Practitioner, Acute Care | 95009361 | CA | Yes |
| 363LA2200X | Nurse Practitioner, Adult Health | 841328 | NV | |
| 363LG0600X | Nurse Practitioner, Gerontology | 841328 | NV |
Practice location
1520 San Pablo St Ste 3800Los Angeles, CA 90033-5328
Phone 323-442-5720
Mailing address
Po Box 31309Los Angeles, CA 90031-0309
Phone 323-442-5720
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