Healthcare Provider Details
I. General information
NPI: 1922482587
Provider Name (Legal Business Name): MRS. HOPE R SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/14/2015
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 S MAIN ST
HOPKINSVILLE KY
42240-2079
US
IV. Provider business mailing address
PO BOX 52
CROFTON KY
42217-0052
US
V. Phone/Fax
- Phone: 270-874-5131
- Fax: 270-874-5513
- Phone: 270-339-3803
- Fax: 270-424-1094
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SF0001X |
| Taxonomy | Family Health Clinical Nurse Specialist |
| License Number | 3009556 |
| License Number State | KY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 3009556 |
| License Number State | KY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: