Healthcare Provider Details

I. General information

NPI: 1851809461
Provider Name (Legal Business Name): BRANDI R SMITH APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2018
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 CHERRY ST
TOLEDO OH
43608-2667
US

IV. Provider business mailing address

5685 N RIVER RD
WATERVILLE OH
43566-9744
US

V. Phone/Fax

Practice location:
  • Phone: 419-244-3053
  • Fax: 419-244-1100
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0026922
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: