Healthcare Provider Details

I. General information

NPI: 1285798579
Provider Name (Legal Business Name): LUCY A SMITH RN MS CS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7603 FOREST AVE SUITE 209 HDH COURTYARD MEDICAL BUILDING
RICHMOND VA
23229-4942
US

IV. Provider business mailing address

2420 HAMPDEN ROW
ROCKVILLE VA
23146-2137
US

V. Phone/Fax

Practice location:
  • Phone: 804-342-0993
  • Fax: 804-749-3480
Mailing address:
  • Phone: 804-342-0993
  • Fax: 804-749-3480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001076110
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number0015000033
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: