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Individual
ELAINE L. SMITH
Active
Individual
ELAINE L. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.R.N.P.
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4288P
KY
363LA2200X
Adult Health Nurse Practitioner
4288P
KY
363LP2300X
Primary Care Nurse Practitioner
4288P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37903705
MEDICAID LAB GROUP
KY
01
—
4000501
MEDICARE LAB GROUP
KY
05
—
78014255
—
KY
01
—
CB5773
RR MEDICARE GROUP
KY
01
—
P00243304
RR MEDICARE PIN
KY
Enumeration date
09/13/2006
Last updated
11/02/2007
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