Individual provider · Type 1 NPI
Petrina Smith
Family Nurse Practitioner · Jackson, MS
NPI number
1124980677
Active
Practice location
2500 N State St
Jackson, MS 39216-4500
Mailing address
919 Willow Grande Cir
Brandon, MS 39047-8315
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 907075 (MS) |
Family Nurse Practitioner: Definition to come...
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About NPI 1124980677
Petrina Smith's National Provider Identifier is 1124980677, issued on Dec 2, 2025. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Jackson, MS. The record was last updated on Dec 2, 2025.