Smith, Lavada Jean

Smith, Lavada Jean is an individual health care provider with primary practice located at 12303 De Paul Dr , Bridgeton MO 63044-2512. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Smith, Lavada Jean can be contacted via phone (314) 317-0600.

Contact Information

Primary practice address
12303 De Paul Dr Bridgeton MO 63044-2512
Phone: (314) 317-0600
Fax: (314) 317-0606
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 150496 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 2090200077 Illinois

Profile Details

NPI number 1164691945
LBN Legal business name Smith, Lavada Jean
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 26th, 2008
Last updated Apr 20th, 2020 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164691945 NPPES
Missouri MEDICAID 1164691945
Missouri MEDICAID 1164691945

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