Provider Demographics
NPI:1629791348
Name:SMITH, ANGEL LATOYA
Entity Type:Individual
Prefix:MS
First Name:ANGEL
Middle Name:LATOYA
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 VISTA ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2636
Mailing Address - Country:US
Mailing Address - Phone:202-321-7346
Mailing Address - Fax:
Practice Address - Street 1:2910 VISTA ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2636
Practice Address - Country:US
Practice Address - Phone:202-321-7346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant