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Individual

MR. KENNETH E SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
3551 BELMONT AVE STE 19B, YOUNGSTOWN, OH 44505-1439
(330) 222-4030
Mailing address
PO BOX 746071, ATLANTA, GA 30374-6071

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN.CNP.05173
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2372614
OH
Enumeration date
05/24/2005
Last updated
10/07/2022
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