Provider Demographics
NPI:1801525183
Name:SMITH, DEANNA K (MIDWIFE)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:K
Last Name:SMITH
Suffix:
Gender:F
Credentials:MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 COUNTY ROAD 7482
Mailing Address - Street 2:
Mailing Address - City:BALDWYN
Mailing Address - State:MS
Mailing Address - Zip Code:38824-8139
Mailing Address - Country:US
Mailing Address - Phone:662-663-1616
Mailing Address - Fax:
Practice Address - Street 1:52 COUNTY ROAD 7482
Practice Address - Street 2:
Practice Address - City:BALDWYN
Practice Address - State:MS
Practice Address - Zip Code:38824-8139
Practice Address - Country:US
Practice Address - Phone:662-663-1616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay