Healthcare Provider Details

I. General information

NPI: 1134033459
Provider Name (Legal Business Name): JESSICA LEANNE SMITH CST,CSFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 GETTYS ST
GETTYSBURG PA
17325-2534
US

IV. Provider business mailing address

28 SHADOW LN
CHAMBERSBURG PA
17202-7014
US

V. Phone/Fax

Practice location:
  • Phone: 717-334-2121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: