Provider Demographics
NPI:1891437828
Name:SMITH, WINDY C (RN)
Entity Type:Individual
Prefix:
First Name:WINDY
Middle Name:C
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 SHERIDAN AVE
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-7736
Mailing Address - Country:US
Mailing Address - Phone:307-587-4279
Mailing Address - Fax:307-587-6405
Practice Address - Street 1:3101 SHERIDAN AVE
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-7736
Practice Address - Country:US
Practice Address - Phone:307-587-4279
Practice Address - Fax:307-587-6405
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY27768163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool