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NPI Code Detail

MEDICARE: AMANDA MARIE SMITH CHW

MEDICARE: AMANDA MARIE SMITH CHW
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
1172V00000XCommunity Health WorkerCHW1-6345NV

General Provider Information

NPI Number : 1891641619
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA MARIE SMITH CHW
Provider Business Mailing Address
First Line : 3035 S MARYLAND PKWY STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-2205
Country : US
Telephone Number : 702-857-8800
Fax Number : 702-857-8801
Provider Business Practice Location Address
First Line : 3035 S MARYLAND PKWY STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-2205
Country : US
Telephone Number : 702-857-8800
Fax Number : 702-857-8801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2026
Last Update Date : 03/05/2026

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Directions to “ AMANDA MARIE SMITH CHW” Practice Location

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