Provider Demographics
NPI:1528769809
Name:SMITH, CHAMBREA PAIGE I (BS)
Entity type:Individual
Prefix:MRS
First Name:CHAMBREA
Middle Name:PAIGE
Last Name:SMITH
Suffix:I
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:CHAMBREA
Other - Middle Name:PAIGE
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:713 SAC DR
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-1250
Mailing Address - Country:US
Mailing Address - Phone:580-478-2526
Mailing Address - Fax:
Practice Address - Street 1:605 W OXFORD AVE
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-1208
Practice Address - Country:US
Practice Address - Phone:580-233-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator