Provider Demographics
NPI:1457681843
Name:SMOOT, MARLENA LYNN (CD)
Entity Type:Individual
Prefix:
First Name:MARLENA
Middle Name:LYNN
Last Name:SMOOT
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:MARLENA
Other - Middle Name:LYNN
Other - Last Name:VAN METER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CD
Mailing Address - Street 1:16184 EDINBURGH DR
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-1623
Mailing Address - Country:US
Mailing Address - Phone:530-550-8996
Mailing Address - Fax:
Practice Address - Street 1:16184 EDINBURGH DR
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-1623
Practice Address - Country:US
Practice Address - Phone:530-550-8996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula