Provider Demographics
NPI:1184262479
Name:SMITH, MARY MARGARITE MAY (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:MARGARITE MAY
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 COLERAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-6414
Mailing Address - Country:US
Mailing Address - Phone:513-740-7044
Mailing Address - Fax:
Practice Address - Street 1:7200 BLUE ASH RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-3626
Practice Address - Country:US
Practice Address - Phone:513-847-6678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-17
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.434434363L00000X
AZ271470363L00000X
OH026129363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner