Provider Demographics
NPI:1740074970
Name:SMITHHEART, ANDREA LEIGH
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:LEIGH
Last Name:SMITHHEART
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:LEIGH
Other - Last Name:HOLDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:822 LARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-3447
Mailing Address - Country:US
Mailing Address - Phone:512-922-6071
Mailing Address - Fax:
Practice Address - Street 1:822 LARKWOOD DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-3447
Practice Address - Country:US
Practice Address - Phone:512-922-6071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC302692163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator