Smith, Justin Warren
Smith, Justin Warren is an sole proprietor health care provider with primary practice located at 200 Abraham Flexner Way , Louisville KY 40202. He recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family, 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, Justin Warren can be contacted via phone (502) 587-4404.Contact Information
Primary practice address
200 Abraham Flexner Way
Louisville KY 40202
Phone: (502) 587-4404
Fax: (502) 587-4156
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Registered Nurse | 163W00000X | 166747 | Tennessee |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 71001350A | Indiana |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 041315277 | Illinois |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 3004228 | Kentucky |
Profile Details
| NPI number | 1700889409 |
|---|---|
| LBN Legal business name | Smith, Justin Warren |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 27th, 2005 |
| Last updated | Aug 22nd, 2018 - about 6 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 | 1700889409 | NPPES |
| Indiana | MEDICAID | 200388540 | |
| Indiana | MEDICAID | 7100372420 | |
| Indiana | Other | K1838900-KOHMG |
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