Provider Demographics
NPI:1104715846
Name:SMITH, SHAMYIA (LNHS, CPS)
Entity type:Individual
Prefix:
First Name:SHAMYIA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LNHS, CPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6911 FOX CROSSING DR APT 118
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-4919
Mailing Address - Country:US
Mailing Address - Phone:919-307-9931
Mailing Address - Fax:
Practice Address - Street 1:6911 FOX CROSSING DR APT 118
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-4919
Practice Address - Country:US
Practice Address - Phone:919-307-9931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH8925224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist