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NPI Code Detail

MEDICARE: KIMBERLY ANN SMITH CPST

MEDICARE: KIMBERLY ANN SMITH CPST
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
1175T00000XPeer SpecialistAPS001219OH
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1912413006
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY ANN SMITH CPST
Provider Business Mailing Address
First Line : 4269 PEARL RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-4234
Country : US
Telephone Number : 216-431-4131
Fax Number : 216-431-4151
Provider Business Practice Location Address
First Line : 2554 W 25TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-4700
Country : US
Telephone Number : 216-781-2250
Fax Number : 216-781-2252
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2017
Last Update Date : 01/16/2024

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Directions to “ KIMBERLY ANN SMITH CPST” Practice Location

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