Healthcare Provider Details

I. General information

NPI: 1831030162
Provider Name (Legal Business Name): VANISHA L SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 W MORRIS AVE STE 3
HAMMOND LA
70403-3854
US

IV. Provider business mailing address

954 HIGHWAY 441
HOLDEN LA
70744-8120
US

V. Phone/Fax

Practice location:
  • Phone: 985-662-3799
  • Fax:
Mailing address:
  • Phone: 256-617-4745
  • 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 StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: