Individual
DR. CYNTHIA ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C-FNP, DNP, APRN
Contact information
Practice address
1540 SPRING VALLEY DR, HUNTINGTON, WV 25704-9501
(304) 429-6741
Mailing address
1540 SPRING VALLEY DR, HUNTINGTON, WV 25704-9501
(304) 429-6741
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
56329
WV
363LP2300X
Primary Care Nurse Practitioner
Primary
APRN56329
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3027156
—
OH
01
—
4000438000
GROUP MEDICAID NUMBER
WV
05
—
7104136000
—
WV
01
—
NP33061
MEDICARE ID
OH
01
—
RE9310001
GROUP ORGANIZATION PTAN
WV
01
—
WV2799A
MEDICARE PTAN
WV
Enumeration date
07/28/2006
Last updated
03/08/2024
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