Provider Demographics
NPI:1487010864
Name:SMYTH, JAMIE ELLEN (CRNA)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:ELLEN
Last Name:SMYTH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:ELLEN
Other - Last Name:CYR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3313 EPHROSS CIR
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-9441
Mailing Address - Country:US
Mailing Address - Phone:203-565-7166
Mailing Address - Fax:
Practice Address - Street 1:3313 EPHROSS CIR
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-9441
Practice Address - Country:US
Practice Address - Phone:203-565-7166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-14
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL6-0A00748367500000X
PARN653504367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered