Provider Demographics
NPI:1053084301
Name:SMITH, KIMBERLY A (PHLEBOTOMIST)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1296 LITITZ PIKE # 1002
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4340
Mailing Address - Country:US
Mailing Address - Phone:717-928-8802
Mailing Address - Fax:717-200-9630
Practice Address - Street 1:56 LANCASTER EST
Practice Address - Street 2:
Practice Address - City:MOUNT JOY
Practice Address - State:PA
Practice Address - Zip Code:17552-1704
Practice Address - Country:US
Practice Address - Phone:717-928-8802
Practice Address - Fax:717-200-9630
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy