Provider Demographics
NPI:1669955910
Name:SMITH, LAUREN MICHELLE (CNP)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:MICHELLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 PROSPECT PL
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-2916
Mailing Address - Country:US
Mailing Address - Phone:513-363-5522
Mailing Address - Fax:513-363-5506
Practice Address - Street 1:636 PROSPECT PL
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2916
Practice Address - Country:US
Practice Address - Phone:513-363-5522
Practice Address - Fax:513-363-5506
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.022527363LP0200X
OH1669955910363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care