MEDICARE: MRS. LINDSEY AARON SMITH CRNP

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	363LF0000X	Family Nurse Practitioner	SP010371	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12057990	OTHER	PA	CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558592386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDSEY AARON SMITH CRNP

Provider Business Mailing Address
First Line	:	647 N BROAD STREET EXT
Second Line	:	SUITE 107
City	:	GROVE CITY
State	:	PA
Zip	:	16127-4604
Country	:	US
Telephone Number	:	724-458-8460
Fax Number	:	724-458-5062

Provider Business Practice Location Address
First Line	:	201 ERIE ST
Second Line	:	SUITE C
City	:	GROVE CITY
State	:	PA
Zip	:	16127-1659
Country	:	US
Telephone Number	:	724-458-7005
Fax Number	:	724-458-5297

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

Provider Enumeration Date	:	07/28/2009
Last Update Date	:	05/08/2017

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