Individual
LYDIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
112 QUARTERHORSE DR, SCOTT DEPOT, WV 25560-9684
(304) 685-1901
Mailing address
112 QUARTERHORSE DR, SCOTT DEPOT, WV 25560-9684
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
63888
WV
363LF0000X
Family Nurse Practitioner
APRN63888
WV
Other
Enumeration date
10/22/2011
Last updated
05/24/2021
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