Provider Demographics
NPI:1962203794
Name:SMITH, VALERIE (LPN/OPERATOR)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:SMITH
Suffix:
Gender:
Credentials:LPN/OPERATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 E FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67505-2028
Mailing Address - Country:US
Mailing Address - Phone:620-664-3367
Mailing Address - Fax:
Practice Address - Street 1:410 N RENO ST
Practice Address - Street 2:
Practice Address - City:HAVEN
Practice Address - State:KS
Practice Address - Zip Code:67543-9276
Practice Address - Country:US
Practice Address - Phone:620-465-2421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44449164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse