Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Miss. Tavia Nikol Smith, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1568813061

Miss. Tavia Nikol Smith, FNP-BC is a Nurse Practitioner in Saint Louis, Missouri. Qualified in 2012, 14 years ago. Practices with Southeastern Physician Services PC, a 598-clinician group. Licensed in Missouri.

Years since qualifying
14
Licensed in
MO
In the registry since
2016
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone: (314) 653-5700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 2015019119 (MO)

Record details

NPI number1568813061
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorYes
NPI enumeratedJune 26, 2016
Last updated in NPPESJune 26, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Southeastern Physician Services Pc — 598 clinicians
Accepts Medicare assignment Not indicated
Practice locations4 on file with Medicare

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