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General NPI Number Information
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NPI Number | 1245504364
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Entity Type | Individual
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Provider Name | MRS. MILLEON SMITH
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Gender | Female
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 4986 KAREN ISLE DR
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City | RICHMOND HEIGHTS
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State | OH
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Zip | 44143-1413
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Country | US
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Telephone | 216-798-5989
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Fax |
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Provider Business Mailing Address
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Address Line | 4986 KAREN ISLE DRIVE
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City | RICHMOND HEIGHTS
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State | OH
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Zip | 44143
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Country | US
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Telephone | 216-798-5989
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 138160
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License Number State | OH
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