Provider Demographics
NPI:1114215332
Name:SMOUT, DENNA ANNETTE
Entity Type:Individual
Prefix:
First Name:DENNA
Middle Name:ANNETTE
Last Name:SMOUT
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 1:473 SMITHRIDGE PARK
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-5766
Mailing Address - Country:US
Mailing Address - Phone:775-846-6255
Mailing Address - Fax:
Practice Address - Street 1:473 SMITHRIDGE PARK
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-5766
Practice Address - Country:US
Practice Address - Phone:775-846-6255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker