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Individual

MR. ANTHONY GERMAINE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CHW II/ PRSS

Contact information

Practice address
4948 MOUNTAIN VISTA ST UNIT 20543, LAS VEGAS, NV 89112-8104
(702) 929-5711
Mailing address
4948 MOUNTAIN VISTA ST UNIT 20543, LAS VEGAS, NV 89112-8104
(702) 929-5711

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
CHW2-5096
NV
175T00000X
Peer Specialist
PRSS-5160
NV
175T00000X
Peer Specialist
PRSS-SUP-5142
NV

Other

Enumeration date
11/29/2024
Last updated
11/02/2025
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