Individual
MR. ROBERT JOHN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
650 JOEL DR, MANAGED CARE DIVISION, FORT CAMPBELL, KY 42223-5318
(270) 798-8766
(630) 570-5225
Mailing address
650 JOEL DR, MANAGED CARE DIVISION, FORT CAMPBELL, KY 42223-5318
(270) 798-8766
(630) 570-5225
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000049998
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPN0000049998
NURSING LICENSE
TN
Enumeration date
04/18/2006
Last updated
07/17/2024
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