Provider Demographics
NPI:1699146753
Name:SMELTZER, LINDA DENISE
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:DENISE
Last Name:SMELTZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3235 N ALTON AVE
Mailing Address - Street 2:APT. C
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-2052
Mailing Address - Country:US
Mailing Address - Phone:317-640-8486
Mailing Address - Fax:
Practice Address - Street 1:3235 N ALTON AVE
Practice Address - Street 2:APT.C
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-2052
Practice Address - Country:US
Practice Address - Phone:317-640-8486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-15
Last Update Date:2016-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker