Provider Demographics
NPI:1740871292
Name:SMITH, DAWN MARIE (CMA)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:CMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-0016
Mailing Address - Country:US
Mailing Address - Phone:937-541-9399
Mailing Address - Fax:
Practice Address - Street 1:5915 STATE ROUTE 589
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:OH
Practice Address - Zip Code:45326-8746
Practice Address - Country:US
Practice Address - Phone:937-541-9399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker