MEDICARE: LEAH 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	163W00000X	Registered Nurse	L1-0045226	DE

General Provider Information

NPI Number	:	1558750786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEAH SMITH

Provider Business Mailing Address
First Line	:	424 SAVANNAH RD
Second Line	:
City	:	LEWES
State	:	DE
Zip	:	19958-1462
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	37125 LORD BALTIMORE LN
Second Line	:
City	:	OCEAN VIEW
State	:	DE
Zip	:	19970-3242
Country	:	US
Telephone Number	:	202-834-1271
Fax Number	:

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

Provider Enumeration Date	:	01/12/2015
Last Update Date	:	01/12/2015

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Directions to “ LEAH SMITH ” Practice Location

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