Individual
NEESHA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
280 PATTONSVILLE RD, JACKSON, OH 45640-9452
(740) 395-8805
(740) 395-8855
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 395-8805
(740) 395-8855
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
161878
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000185174
OH MEDICAID UNISON
OH
01
—
000000312590
ANTHEM BCBS
—
05
—
2245252
—
OH
01
—
500016983
RR MEDICARE
—
05
—
7105059000
—
WV
Enumeration date
07/19/2006
Last updated
12/22/2020
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