Doctor Name: | JENNIFER LEE SMITH |
NPI Number: | 1023259603 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNP |
License Number: | COA10628NP |
Business Practice Address: | 4900 Oak Street Berlin, OH - 446100426 |
Business Phone Number: | 3308931318 |
Business Fax Number: | 3308931485 |
Mailing Address: | Po Box 426, BERLIN |
State: | OH |
Postal Code: | 446100426 |
Phone Number: | 3308931318 |
Fax Number: | 3308931485 |
NPI Enumeration Date: | 03/12/2009 |
NPI Last Update Date: | 03/31/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | COA10628NP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |