Provider Demographics
NPI:1891309142
Name:SMITH, NATASHA N
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:N
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 1:31555 SAMUEL BROWN RD
Mailing Address - Street 2:
Mailing Address - City:ANGIE
Mailing Address - State:LA
Mailing Address - Zip Code:70426-2101
Mailing Address - Country:US
Mailing Address - Phone:985-750-3444
Mailing Address - Fax:
Practice Address - Street 1:31555 SAMUEL BROWN RD
Practice Address - Street 2:
Practice Address - City:ANGIE
Practice Address - State:LA
Practice Address - Zip Code:70426-2101
Practice Address - Country:US
Practice Address - Phone:985-750-3444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health