Provider Demographics
NPI:1851814925
Name:SMILEY, REBECCA LYNNE (NP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNNE
Last Name:SMILEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:LYNNE
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:500 THOMAS LN STE 3A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1419
Mailing Address - Country:US
Mailing Address - Phone:614-566-2500
Mailing Address - Fax:614-533-0335
Practice Address - Street 1:500 THOMAS LN STE 3A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1419
Practice Address - Country:US
Practice Address - Phone:614-566-2500
Practice Address - Fax:614-533-0335
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031193363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA$$$$$$$$$Medicaid