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General NPI Number Information
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NPI Number | 1144686825
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Entity Type | Individual
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Provider Name | JOSHUA ALLEN SMITH FRUEAUF CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/11/2016
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Last Update Date | 08/06/2018
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Provider Practice Location Address
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Address Line | 1001 BELLEFONTAINE AVE
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City | LIMA
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State | OH
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Zip | 45804
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Country | US
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Telephone | 419-228-3335
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Fax |
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Provider Business Mailing Address
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Address Line | 2560 EMERALD WAY
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City | WAYNESVILLE
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State | OH
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Zip | 45068-9669
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Country | US
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Telephone | 937-694-7078
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | COA.18577-NA
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License Number State | OH
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