Provider Demographics
NPI:1952079303
Name:KASHA SMITH, LAUREN ALEXANDRA (APRN)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ALEXANDRA
Last Name:KASHA SMITH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 15415
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47716-0415
Mailing Address - Country:US
Mailing Address - Phone:812-477-9495
Mailing Address - Fax:812-477-0134
Practice Address - Street 1:999 S KENMORE DR STE A
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-7514
Practice Address - Country:US
Practice Address - Phone:812-477-9495
Practice Address - Fax:812-477-0134
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71011503A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner