Healthcare Provider Details

I. General information

NPI: 1194668590
Provider Name (Legal Business Name): ASHLEY SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 KILBOURN AVE
DENMARK IA
52624-7762
US

IV. Provider business mailing address

PO BOX 307
DENMARK IA
52624-0307
US

V. Phone/Fax

Practice location:
  • Phone: 319-470-4246
  • Fax:
Mailing address:
  • Phone: 319-470-4246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: