Provider Demographics
NPI:1245302678
Name:SMITH, NANCY K (RNC BSN)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:K
Last Name:SMITH
Suffix:
Gender:F
Credentials:RNC BSN
Other - Prefix:MRS
Other - First Name:NANCY
Other - Middle Name:K
Other - Last Name:WESTBROOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RNC BSN
Mailing Address - Street 1:1421 COBURG ROAD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227
Mailing Address - Country:US
Mailing Address - Phone:614-237-6023
Mailing Address - Fax:614-237-6023
Practice Address - Street 1:1421 COBURG ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227
Practice Address - Country:US
Practice Address - Phone:614-237-6023
Practice Address - Fax:614-237-6023
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2008-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN198620163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2096502Medicaid