TYANGALA BRACEY SMITH
NPI 1861167363
Nurse Practitioner - Family in Gulfport, MS
Active since August 16, 2021
About Tyangala Bracey Smith NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TYANGALA BRACEY SMITH (NPI 1861167363) is an individual family provider in Gulfport, Mississippi, licensed in Mississippi (904739) and active in the NPI registry since August 2021.
NPPES Registry Identity
NPI1861167363
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameTYANGALA BRACEY SMITH
Location Address12104 HARMONY CIRGulfport, MS 39503-9534
Mailing Address12104 Harmony CirGulfport, MS 39503-9534 · (601) 454-9778
Phone(601) 454-9778
Sole ProprietorNo
Enumeration DateAugust 16, 2021
NPPES CertifiedAugust 16, 2021
✔ NPI 1861167363 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MS · 904739
12104 HARMONY CIR, Gulfport, MS 39503
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1861167363, enumerated as an "individual" on August 16, 2021.
The provider is located at 12104 HARMONY CIR GULFPORT, MS 39503 and the phone number is (601) 454-9778.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
