Provider Demographics
NPI:1295877256
Name:SMITH, NANCY BETH (PA-C)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:BETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:JOHNS HOPKINS OUTPATIENT CENTER
Mailing Address - Street 2:610 N. CAROLINE ST., 6TH FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0910
Mailing Address - Country:US
Mailing Address - Phone:410-955-7381
Mailing Address - Fax:410-614-8610
Practice Address - Street 1:1800 ORLEANS STREET
Practice Address - Street 2:PARK 1 INFUSION CENTER
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287
Practice Address - Country:US
Practice Address - Phone:443-287-8288
Practice Address - Fax:410-614-0686
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDU02416171100000X
MDC0000699363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD164499YVBMedicare PIN