Provider Demographics
NPI:1205906492
Name:SMITHA, LISA LYNN (NP)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:LYNN
Last Name:SMITHA
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:720 ESKENAZI AVE
Mailing Address - Street 2:FIFTH THIRD BANK BLDG, 5TH FL
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5166
Mailing Address - Country:US
Mailing Address - Phone:317-880-4121
Mailing Address - Fax:317-880-0343
Practice Address - Street 1:6920 PARKDALE PL STE 107
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-5604
Practice Address - Country:US
Practice Address - Phone:317-880-2276
Practice Address - Fax:317-251-7374
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2021-11-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN71000860A363L00000X
IN28106992A363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health