Provider Demographics
NPI:1073132890
Name:SMITH, ANITA S
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:S
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21310 CASTAWAY CIR UNIT 103
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653-6520
Mailing Address - Country:US
Mailing Address - Phone:240-346-9392
Mailing Address - Fax:
Practice Address - Street 1:2800 SHIPLEY TER SE APT 101
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-1814
Practice Address - Country:US
Practice Address - Phone:240-346-9392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-12
Last Update Date:2020-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000OtherNONE