Individual
TANISHA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
211 W 34TH CT, APT 3, GRIFFITH, IN 46319-1023
(708) 238-2166
Mailing address
211 W 34TH CT, APT 3, GRIFFITH, IN 46319-1023
(708) 238-2166
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.109384
IL
Other
Enumeration date
03/30/2012
Last updated
03/30/2012
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