Provider Demographics
NPI:1558336255
Name:SMITH, APRIL LYNN (PA C)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:LYNN
Last Name:SMITH
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:LYNN
Other - Last Name:SMALLACOMBE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA C
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:844-362-1773
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:222 RED SCHOOL LN
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-2219
Practice Address - Country:US
Practice Address - Phone:908-760-3211
Practice Address - Fax:908-760-3212
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051876363A00000X
NJ25MP00177800363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q26986Medicare UPIN
084726E3TMedicare ID - Type Unspecified