Provider Demographics
NPI:1407646557
Name:SMYTH, ANDREA DIANE
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:DIANE
Last Name:SMYTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:DIANE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WV
Mailing Address - Zip Code:26807-0009
Mailing Address - Country:US
Mailing Address - Phone:304-358-2421
Mailing Address - Fax:
Practice Address - Street 1:365 MILL RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WV
Practice Address - Zip Code:26807-6609
Practice Address - Country:US
Practice Address - Phone:304-358-2421
Practice Address - Fax:304-358-2421
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care