Provider Demographics
NPI:1083847529
Name:SMITH, HANNAH LEIGH (LPN)
Entity Type:Individual
Prefix:MISS
First Name:HANNAH
Middle Name:LEIGH
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1662 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-3455
Mailing Address - Country:US
Mailing Address - Phone:419-561-1455
Mailing Address - Fax:
Practice Address - Street 1:1662 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-3455
Practice Address - Country:US
Practice Address - Phone:419-561-1455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH135390164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse