Provider Demographics
NPI:1700567625
Name:SMITH, PATRICIA LYNN
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYNN
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14945 ALBERT HORNING AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-9730
Mailing Address - Country:US
Mailing Address - Phone:330-314-3548
Mailing Address - Fax:
Practice Address - Street 1:14945 ALBERT HORNING AVE NE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-9730
Practice Address - Country:US
Practice Address - Phone:330-314-3548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide