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General NPI Number Information
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NPI Number | 1154343747
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Entity Type | Individual
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Provider Name | NANCY J SMITH DO
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Gender | Female
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 3095 KETTERING BLVD
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City | MORAINE
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State | OH
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Zip | 45439-1983
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Country | US
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Telephone | 937-293-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 601 S EDWIN C MOSES BLVD
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City | DAYTON
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State | OH
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Zip | 45417-3424
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Country | US
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Telephone | 937-734-8333
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Fax | 937-384-4845
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 34.050625
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 3405625
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License Number State | OH
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