Provider Demographics
NPI:1922092204
Name:SMITH, CLAUDIA PAULETTE (CSA)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:PAULETTE
Last Name:SMITH
Suffix:
Gender:F
Credentials:CSA
Other - Prefix:MISS
Other - First Name:CLAUDIA
Other - Middle Name:PAULETTE
Other - Last Name:SHRULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P O BOX 950202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0202
Mailing Address - Country:US
Mailing Address - Phone:502-969-6552
Mailing Address - Fax:502-969-3799
Practice Address - Street 1:3900 KRESGE WAY STE 51
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4683
Practice Address - Country:US
Practice Address - Phone:502-891-8981
Practice Address - Fax:502-891-4548
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYSA064246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000602599OtherANTHEM- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY