Provider Demographics
NPI:1912338534
Name:SMITH, AIMEE LYNNE (APRN)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:LYNNE
Last Name:SMITH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2400 E BUFFALO AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-7906
Mailing Address - Country:US
Mailing Address - Phone:716-989-8980
Mailing Address - Fax:
Practice Address - Street 1:1930 BISHOP LN FL 12
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-1921
Practice Address - Country:US
Practice Address - Phone:502-272-5220
Practice Address - Fax:502-272-5117
Is Sole Proprietor?:No
Enumeration Date:2013-12-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY659970-1163W00000X
KY30011593363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse