Individual
LYNN M SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
20 SAYBROOK RD, ESSEX, CT 06426-1401
(860) 938-2362
Mailing address
3 COACH DR, OLD LYME, CT 06371-1354
(860) 938-2362
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
5005
CT
363LA2200X
Adult Health Nurse Practitioner
Primary
005005
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720333487
—
CT
Enumeration date
07/18/2012
Last updated
05/12/2020
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