MEDICARE: PATRICIA 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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1568240349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA SMITH

Provider Business Mailing Address
First Line	:	2702 DOUGLASS PL SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-4486
Country	:	US
Telephone Number	:	202-704-9829
Fax Number	:

Provider Business Practice Location Address
First Line	:	5120 D ST SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-6121
Country	:	US
Telephone Number	:	202-394-5125
Fax Number	:

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

Provider Enumeration Date	:	09/21/2023
Last Update Date	:	09/21/2023

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Directions to “ PATRICIA SMITH ” Practice Location

Language	Start Address	Practice Location

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