Provider Demographics
NPI:1972990489
Name:SMINK, IVY (RN, CNS)
Entity Type:Individual
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First Name:IVY
Middle Name:
Last Name:SMINK
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Gender:F
Credentials:RN, CNS
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Mailing Address - Street 1:10 DISTILLERY LANE SUITE 200
Mailing Address - Street 2:CARROLL COUNTY HEALTH DEPARTMENT BUREAU OF PREVENTION W
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157
Mailing Address - Country:US
Mailing Address - Phone:410-871-1478
Mailing Address - Fax:443-952-7599
Practice Address - Street 1:10 DISTILLERY LANE SUITE 200
Practice Address - Street 2:CARROLL COUNTY HEALTH DEPARTMENT BUREAU OF PREVENTION W
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157
Practice Address - Country:US
Practice Address - Phone:410-871-1478
Practice Address - Fax:443-952-7599
Is Sole Proprietor?:No
Enumeration Date:2015-04-22
Last Update Date:2016-11-29
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Provider Licenses
StateLicense IDTaxonomies
MDR075492163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)