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1376557017

NPI Code Detail

MEDICARE: DR. CYNTHIA ANN SMITH C-FNP, DNP, APRN

MEDICARE: DR. CYNTHIA ANN SMITH C-FNP, DNP, APRN

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	363L00000X	Nurse Practitioner	56329	WV
2	363LP2300X	Primary Care Nurse Practitioner	APRN56329	WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	NP33061	OTHER	OH	MEDICARE ID
5	WV2799A	OTHER	WV	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	RE9310001	OTHER	WV	GROUP ORGANIZATION PTAN
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376557017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA ANN SMITH C-FNP, DNP, APRN

Provider Business Mailing Address
First Line	:	1540 SPRING VALLEY DR
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25704-9501
Country	:	US
Telephone Number	:	304-429-6741
Fax Number	:

Provider Business Practice Location Address
First Line	:	1540 SPRING VALLEY DR
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25704-9501
Country	:	US
Telephone Number	:	304-429-6741
Fax Number	:

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

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	03/08/2024

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Directions to “ DR. CYNTHIA ANN SMITH C-FNP, DNP, APRN” Practice Location

Language	Start Address	Practice Location

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