Provider Information for 1457897233
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YVETTE SMITH
Other Names:Former Name:YVETTE WOSLEYSex: Female
NPI: 1457897233
Last Updated: 2019-11-13
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1457897233 | ||||||||
| Enumeration Date | 2017-01-17 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 614 HOPKINSVILLE, KY 42241-0614 United States Phone: 270-886-2205 | Fax:270-886-0392 | ||||||||
| Primary Practice Address | 290 BURLEY AVE HOPKINSVILLE, KY 42240-8725 United States Phone: 270-707-2098 | Fax:270-707-2099 | ||||||||
| Secondary Practice Address(es) | 2400 RUSSELLVILLE RD 737B NORTH DR | ||||||||
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