Provider Demographics
NPI:1245664085
Name:SMITH, BILLI JEAN (NP)
Entity type:Individual
Prefix:MRS
First Name:BILLI
Middle Name:JEAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3840 NY-31
Mailing Address - Street 2:
Mailing Address - City:CLAY
Mailing Address - State:NY
Mailing Address - Zip Code:13090-9010
Mailing Address - Country:US
Mailing Address - Phone:315-715-6319
Mailing Address - Fax:
Practice Address - Street 1:8131 MCCAMBIGE DRIVE
Practice Address - Street 2:
Practice Address - City:CICERO NY
Practice Address - State:NY
Practice Address - Zip Code:13039
Practice Address - Country:US
Practice Address - Phone:719-459-1514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-28
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY812686163W00000X
NY347528363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse