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General NPI Number Information
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NPI Number | 1740801232
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Entity Type | Individual
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Provider Name | AMY SMITH MS, CNS, LDN, BCHN
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Gender | Female
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Dates
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Enumeration Date | 05/06/2020
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 10451 MILL RUN CIR STE 400
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5594
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Country | US
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Telephone | 276-475-8848
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Fax | 276-222-6916
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Provider Business Mailing Address
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Address Line | 553 WYNDALE RD
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City | ABINGDON
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State | VA
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Zip | 24210-4721
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Country | US
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Telephone | 423-863-3072
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | DX5177
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | CNS18228
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 164.00899
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | DN-0010852
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License Number State | DE
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Taxonomy #6
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DN-0010852
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License Number State | DE
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Taxonomy #7
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DX5177
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License Number State | MD
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Taxonomy #8
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 164.00899
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License Number State | IL
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