Healthcare Provider Details

I. General information

NPI: 1225847122
Provider Name (Legal Business Name): ASHLEY SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 PIERCE ST
SIOUX CITY IA
51101-1414
US

IV. Provider business mailing address

2901 STONE PARK BLVD
SIOUX CITY IA
51104-3901
US

V. Phone/Fax

Practice location:
  • Phone: 712-355-9550
  • Fax:
Mailing address:
  • Phone: 712-490-2163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: