Provider Demographics
NPI:1811788722
Name:SMITH, CHARLENE ANNETTE
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:ANNETTE
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHARLENE
Other - Middle Name:ANNETTE
Other - Last Name:RIENKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5001 NW 1ST ST STE 7
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-4498
Mailing Address - Country:US
Mailing Address - Phone:402-853-4929
Mailing Address - Fax:
Practice Address - Street 1:5001 NW 1ST ST STE 7
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-4498
Practice Address - Country:US
Practice Address - Phone:402-853-4929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant