MEDICARE: CHIKITA SMITH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172A00000X	Driver

General Provider Information

NPI Number	:	1295240737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHIKITA SMITH

Provider Business Mailing Address
First Line	:	101 S CEDAR AVE
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23075-1310
Country	:	US
Telephone Number	:	804-665-6612
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 S CEDAR AVE
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23075-1310
Country	:	US
Telephone Number	:	804-665-6612
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2017
Last Update Date	:	12/06/2017

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Directions to “ CHIKITA SMITH ” Practice Location

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