Provider Demographics
NPI:1972791887
Name:SMITH, DON (RN)
Entity type:Individual
Prefix:
First Name:DON
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12861 LORI LEE LANE
Mailing Address - Street 2:
Mailing Address - City:FRIENDSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45630
Mailing Address - Country:US
Mailing Address - Phone:740-858-2133
Mailing Address - Fax:
Practice Address - Street 1:12861 LORI LEE LANE
Practice Address - Street 2:
Practice Address - City:FRIENDSHIP
Practice Address - State:OH
Practice Address - Zip Code:45630
Practice Address - Country:US
Practice Address - Phone:740-858-2133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH211201163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse