Smith, Michael

Smith, Michael is an individual health care provider with primary practice located at 20 Medical Village Dr Suite 258, Edgewood KY 41017. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Smith, Michael can be contacted via phone (859) 301-2211.

Contact Information

Primary practice address
20 Medical Village Dr Suite 258 Edgewood KY 41017
Phone: (859) 301-2211
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 1054975 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 037860 Kentucky

Profile Details

NPI number 1487630091
LBN Legal business name Smith, Michael
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 16th, 2005
Last updated Apr 20th, 2008 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487630091 NPPES
Kentucky MEDICAID 74097817
Kentucky MEDICAID 2166454
Kentucky Other 000000389807

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