Provider Demographics
NPI:1952952236
Name:SMITH, ALEXIA KAYE
Entity Type:Individual
Prefix:
First Name:ALEXIA
Middle Name:KAYE
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEXIA
Other - Middle Name:KAYE
Other - Last Name:NEWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:997 AMHERST DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-6901
Mailing Address - Country:US
Mailing Address - Phone:740-361-1007
Mailing Address - Fax:
Practice Address - Street 1:997 AMHERST DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6901
Practice Address - Country:US
Practice Address - Phone:740-361-1007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-26
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401518620513376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty