Individual
DEBORAH A SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5272 POLEN DR, KETTERING, OH 45440-2558
(937) 572-1158
Mailing address
5272 POLEN DR, KETTERING, OH 45440
(937) 572-1158
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1095565
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051513939
BLUE CROSS
AL
01
—
430080115
RAILROAD MEDICARE
AL
Enumeration date
05/24/2006
Last updated
05/25/2008
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