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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 2 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 1679749014 NPPES
Ohio MEDICAID 0277704
Ohio Other 50.005136RX

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