Healthcare Provider Details

I. General information

NPI: 1558848283
Provider Name (Legal Business Name): MONICA A SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2018
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 E WILDERNESS RD
NATCHEZ MS
39120-8504
US

IV. Provider business mailing address

179 MORGANTOWN RD
NATCHEZ MS
39120-1701
US

V. Phone/Fax

Practice location:
  • Phone: 601-443-7998
  • Fax:
Mailing address:
  • Phone: 601-443-7998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateMS
# 4
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateMS
# 5
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: