Smith, Preston S
Smith, Preston S is an individual health care provider with primary practice located at 215 E Hawaii Ave , Nampa ID 83686-6011. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Smith, Preston S can be contacted via phone (208) 468-5930.Contact Information
Primary practice address
215 E Hawaii Ave
Nampa ID 83686-6011
Phone: (208) 468-5930
Fax: (208) 463-3044
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA464 | Idaho |
Profile Details
| NPI number | 1992794929 |
|---|---|
| LBN Legal business name | Smith, Preston S |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 21st, 2005 |
| Last updated | Nov 1st, 2023 - about last year |
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 | 1992794929 | NPPES |
| Idaho | Other | 000010145450 | BLUE SHIELD |
| Idaho | Other | DAGV3 | BLUE SHIELD |
| Idaho | Other | 000010145449 | BLUE SHIELD |
| Idaho | MEDICAID | 806749400 | BLUE SHIELD |
| Idaho | Other | PAG001 | BLUE SHIELD |
| Idaho | Other | P00160006 | BLUE SHIELD |
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