Provider Demographics
NPI:1417222381
Name:SMITH, ANNE M (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:M
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 1:1114 E TURTLECREEK UNION RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-9655
Mailing Address - Country:US
Mailing Address - Phone:513-658-1228
Mailing Address - Fax:
Practice Address - Street 1:1114 E TURTLECREEK UNION RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-9655
Practice Address - Country:US
Practice Address - Phone:513-658-1228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 148174-M-IV164W00000X
OHRN.398283163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse