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NPI Code Detail

MEDICARE: ASHLEY LYNN SMITH RD,LD,CDE

MEDICARE:   ASHLEY LYNN SMITH  RD,LD,CDE
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
1133V00000XRegistered Dietitian983979CA
2133V00000XRegistered Dietitian983979IL

General Provider Information

NPI Number : 1326356551
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY LYNN SMITH RD,LD,CDE
Provider Business Mailing Address
First Line : 2675 WINDMILL PKWY APT 3623
Second Line :
City : HENDERSON
State : NV
Zip : 89074-7314
Country : US
Telephone Number : 360-481-7176
Fax Number :
Provider Business Practice Location Address
First Line : 6330 S PECOS RD STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-6216
Country : US
Telephone Number : 360-481-7176
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2010
Last Update Date : 04/23/2018

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Directions to “ ASHLEY LYNN SMITH RD,LD,CDE” Practice Location

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