Provider Demographics
NPI:1801382684
Name:EVANS SMITH, PAIGE ELIZABETH (NP-C)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:ELIZABETH
Last Name:EVANS 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 1:2489 290TH AVE
Mailing Address - Street 2:
Mailing Address - City:TERRIL
Mailing Address - State:IA
Mailing Address - Zip Code:51364-7016
Mailing Address - Country:US
Mailing Address - Phone:712-380-0122
Mailing Address - Fax:
Practice Address - Street 1:619 2ND AVE N
Practice Address - Street 2:
Practice Address - City:ESTHERVILLE
Practice Address - State:IA
Practice Address - Zip Code:51334-1942
Practice Address - Country:US
Practice Address - Phone:712-362-2404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG175357363LP0808X
IAA130884363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health