Provider Demographics
NPI:1962187161
Name:SMITH, LYNN ANITA
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:ANITA
Last Name:SMITH
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 1:1920 DUTCH VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4153
Mailing Address - Country:US
Mailing Address - Phone:240-424-7396
Mailing Address - Fax:
Practice Address - Street 1:1920 DUTCH VILLAGE DR
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-4153
Practice Address - Country:US
Practice Address - Phone:240-424-7396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide