MEDICARE: LAWANNA RENAE 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	RN422666	OH

General Provider Information

NPI Number	:	1619479375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWANNA RENAE SMITH

Provider Business Mailing Address
First Line	:	1866 CELESTE CIR
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44511-1008
Country	:	US
Telephone Number	:	330-792-0266
Fax Number	:

Provider Business Practice Location Address
First Line	:	1866 CELESTE CIR
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44511-1008
Country	:	US
Telephone Number	:	330-792-0266
Fax Number	:

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

Provider Enumeration Date	:	03/08/2018
Last Update Date	:	10/13/2023

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Directions to “ LAWANNA RENAE SMITH ” Practice Location

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