Provider Demographics
NPI:1376916106
Name:SMITH, GINGER M (APRN)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:100 E LIBERTY ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1434
Mailing Address - Country:US
Mailing Address - Phone:606-330-7807
Mailing Address - Fax:606-330-7825
Practice Address - Street 1:145 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:KY
Practice Address - Zip Code:40972-6409
Practice Address - Country:US
Practice Address - Phone:606-847-4000
Practice Address - Fax:606-847-9331
Is Sole Proprietor?:No
Enumeration Date:2015-11-02
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY3009845363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100376710Medicaid
13648224OtherCAQH
KYMS4240898OtherDEA