Individual
JESSICA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6140 S BROADWAY, LORAIN, OH 44053-3891
(440) 204-4315
(440) 204-4315
Mailing address
6140 S BROADWAY, LORAIN, OH 44053-3891
(440) 204-4315
(440) 204-4315
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.396336
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.024899
OH
Other
Enumeration date
04/14/2017
Last updated
06/20/2019
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