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Individual

MRS. HEATHER DEETTE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
325 BEECH ST, WAUSEON, OH 43567-1448
(419) 335-2313
Mailing address
1285 N SHOOP AVE, LOT 114, WAUSEON, OH 43567-1847
(419) 704-8585

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
129339
OH
376K00000X
Nurse's Aide
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PN 129339
STATE OF OHIO LPN LICENSURE
OH
Enumeration date
11/07/2006
Last updated
07/18/2012
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