Healthcare Provider Details

I. General information

NPI: 1043780968
Provider Name (Legal Business Name): CHARITY FAITH SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2018
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 ROCKDALE RD
FOLLANSBEE WV
26037-1658
US

IV. Provider business mailing address

560 STEUBENVILLE PIKE
BURGETTSTOWN PA
15021-8539
US

V. Phone/Fax

Practice location:
  • Phone: 304-794-9701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN91991
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberAPRN91991-FNP-BC
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: