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General NPI Number Information
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NPI Number | 1275126617
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Entity Type | Individual
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Provider Name | TERESA ANN SMITH APRN
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Gender | Female
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Dates
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Enumeration Date | 02/17/2021
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 5108 SANDY LN
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City | FAIRFIELD
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State | OH
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Zip | 45014-2738
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Country | US
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Telephone | 866-934-7450
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Fax |
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Provider Business Mailing Address
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Address Line | 4600 MONTGOMERY RD STE 400
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City | CINCINNATI
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State | OH
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Zip | 45212-2600
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 380425
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R51285
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R51285
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License Number State | ND
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3015595
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0029769
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License Number State | OH
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