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General NPI Number Information
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NPI Number | 1720333487
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Entity Type | Individual
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Provider Name | LYNN M SMITH APRN
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Gender | Female
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | 20 SAYBROOK RD
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City | ESSEX
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State | CT
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Zip | 06426-1401
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Country | US
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Telephone | 860-938-2362
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Fax |
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Provider Business Mailing Address
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Address Line | 3 COACH DR
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City | OLD LYME
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State | CT
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Zip | 06371-1354
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Country | US
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Telephone | 860-938-2362
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 5005
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 005005
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License Number State | CT
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