Provider Demographics
NPI:1467606178
Name:SMITH, DONNA KAY BOYD (NP-C)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:KAY BOYD
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29325 HEALTH CAMPUS DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-8201
Mailing Address - Country:US
Mailing Address - Phone:440-414-9412
Mailing Address - Fax:440-414-9059
Practice Address - Street 1:3600 KOLBE RD
Practice Address - Street 2:SUITE 127
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1654
Practice Address - Country:US
Practice Address - Phone:440-414-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-10197363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3025372Medicaid
OH3025372Medicaid