Provider Demographics
NPI:1114297355
Name:SMITH, TONI LYNN (RN)
Entity Type:Individual
Prefix:MS
First Name:TONI
Middle Name:LYNN
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N CAPITOL AVE
Mailing Address - Street 2:E416
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-1218
Mailing Address - Country:US
Mailing Address - Phone:317-962-0098
Mailing Address - Fax:317-962-0071
Practice Address - Street 1:1800 N CAPITOL AVE
Practice Address - Street 2:E416
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1218
Practice Address - Country:US
Practice Address - Phone:317-962-0098
Practice Address - Fax:317-962-0071
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28114104A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse