Healthcare Provider Details

I. General information

NPI: 1609703636
Provider Name (Legal Business Name): LUCY HOLLOWAY SMITH MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 NEW FRONTIER WAY
HAMPTON VA
23665-2460
US

IV. Provider business mailing address

6 NEW FRONTIER WAY
HAMPTON VA
23665-2460
US

V. Phone/Fax

Practice location:
  • Phone: 434-774-9086
  • Fax:
Mailing address:
  • Phone: 434-774-9086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number0001320913
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: