Provider Demographics
NPI:1609177716
Name:SMITH, JEAN MARY (CST/CFA)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:MARY
Last Name:SMITH
Suffix:
Gender:F
Credentials:CST/CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MEADOWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03235-2118
Mailing Address - Country:US
Mailing Address - Phone:603-934-3494
Mailing Address - Fax:
Practice Address - Street 1:6 MEADOWOOD DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235-2118
Practice Address - Country:US
Practice Address - Phone:603-934-3494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant