MEDICARE: JOHNEKA LOVE SMITH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide	L00007794957	DC

General Provider Information

NPI Number	:	1063207520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHNEKA LOVE SMITH

Provider Business Mailing Address
First Line	:	4709 ADDISON RD
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-1102
Country	:	US
Telephone Number	:	301-213-6109
Fax Number	:

Provider Business Practice Location Address
First Line	:	1431 BELLE HAVEN DR
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20785-4416
Country	:	US
Telephone Number	:	301-448-5476
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2025
Last Update Date	:	04/14/2025

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