Healthcare Provider Details

I. General information

NPI: 1003794348
Provider Name (Legal Business Name): LINDSEY SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W BRECKINRIDGE ST
LOUISVILLE KY
40203-2219
US

IV. Provider business mailing address

1615 BLACKISTON MILL RD UNIT 606
CLARKSVILLE IN
47129-1386
US

V. Phone/Fax

Practice location:
  • Phone: 502-901-9664
  • Fax:
Mailing address:
  • Phone: 502-999-8760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: