Healthcare Provider Details

I. General information

NPI: 1295877256
Provider Name (Legal Business Name): NANCY BETH SMITH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ORLEANS STREET PARK 1 INFUSION CENTER
BALTIMORE MD
21287
US

IV. Provider business mailing address

JOHNS HOPKINS OUTPATIENT CENTER 610 N. CAROLINE ST., 6TH FLOOR
BALTIMORE MD
21287-0910
US

V. Phone/Fax

Practice location:
  • Phone: 443-287-8288
  • Fax: 410-614-0686
Mailing address:
  • Phone: 410-955-7381
  • Fax: 410-614-8610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU02416
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberC0000699
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: