Basic Information
| Provider Information | |||||||||
| NPI: | 1922097336 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | FRANCES | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | CANP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 319 W LORAIN ST | ||||||||
| Address2: | |||||||||
| City: | OBERLIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440741027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4407751881 | ||||||||
| FaxNumber: | 4407745707 | ||||||||
| Practice Location | |||||||||
| Address1: | 319 W LORAIN ST | ||||||||
| Address2: | |||||||||
| City: | OBERLIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440741027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4407751881 | ||||||||
| FaxNumber: | 4407745707 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN146015 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | NP 1597 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 2338858 | 05 | OH | MEDICAID |