Individual
TARA LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
210 MARIE LANGDON DR, MANCHESTER, KY 40962-6388
(606) 598-5104
(606) 598-0983
Mailing address
210 MARIE LANGDON DR, MANCHESTER, KY 40962-6388
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3012433
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3012433
KY
Other
Enumeration date
07/20/2018
Last updated
12/03/2024
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