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General NPI Number Information
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NPI Number | 1063379659
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Entity Type | Individual
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Provider Name | TAMEKA SHANTE SMITH LPN
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Gender | Female
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 2632 WOODMAN CENTER CT
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City | KETTERING
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State | OH
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Zip | 45420-1477
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Country | US
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Telephone | 937-739-7100
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Fax | 480-687-7361
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Provider Business Mailing Address
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Address Line | 8444 N 90TH ST STE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4437
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Country | US
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Telephone | 602-248-8886
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Fax | 602-854-0504
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LPN.152555.MEDS-IV
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License Number State | OH
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