MEDICARE: PAULA 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	363LA2100X	Acute Care Nurse Practitioner	0032197	OH

General Provider Information

NPI Number	:	1538882030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA SMITH

Provider Business Mailing Address
First Line	:	306 EUCLID AVE
Second Line	:
City	:	BELLEVUE
State	:	OH
Zip	:	44811-1004
Country	:	US
Telephone Number	:	419-603-0633
Fax Number	:

Provider Business Practice Location Address
First Line	:	306 EUCLID AVE
Second Line	:
City	:	BELLEVUE
State	:	OH
Zip	:	44811-1004
Country	:	US
Telephone Number	:	419-603-0633
Fax Number	:

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

Provider Enumeration Date	:	09/21/2022
Last Update Date	:	09/21/2022

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Directions to “ PAULA SMITH ” Practice Location

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