Smith, Amanda Lucille
Smith, Amanda Lucille is an individual health care provider with primary practice located at 838 E Wooster St , Bowling Green OH 43402-3186. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Smith, Amanda Lucille can be contacted via phone (419) 372-2271.Contact Information
Primary practice address
838 E Wooster St
Bowling Green OH 43402-3186
Phone: (419) 372-2271
Fax: (419) 354-3222
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | MA055640 | Pennsylvania |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA9104163 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 50.005136RX | Ohio |
Profile Details
| NPI number | 1679749014 |
|---|---|
| LBN Legal business name | Smith, Amanda Lucille |
| Credentials | PAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 6th, 2008 |
| Last updated | Jun 15th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679749014 | NPPES |
| Ohio | MEDICAID | 0277704 | |
| Ohio | Other | 50.005136RX |
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