Provider Demographics
NPI:1053135996
Name:SMITH, PAIGE MARIE (LPN)
Entity type:Individual
Prefix:MISS
First Name:PAIGE
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26431 N RUN RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:45710-9033
Mailing Address - Country:US
Mailing Address - Phone:740-517-3744
Mailing Address - Fax:
Practice Address - Street 1:8978 UNITED LN STE 102
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-3668
Practice Address - Country:US
Practice Address - Phone:740-274-4246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH184485164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse