Individual
DR. LYNETTE S SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, PMHNP, FNP
Contact information
Practice address
2642 CHANDLER DR APT 1814, BOWLING GREEN, KY 42104-6257
(812) 021-0222
Mailing address
2642 CHANDLER DR APT 1814, BOWLING GREEN, KY 42104-6257
(812) 201-0222
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
3007259
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3007259
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000543710
ANTHEM PIN
IN
05
—
200334480A
—
IN
Enumeration date
07/14/2006
Last updated
01/07/2015
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