Provider Demographics
NPI:1689495038
Name:PARTRIDGE SMITH, EMILLIE (PA-C)
Entity type:Individual
Prefix:
First Name:EMILLIE
Middle Name:
Last Name:PARTRIDGE SMITH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 DRYDEN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1646
Mailing Address - Country:US
Mailing Address - Phone:937-479-7632
Mailing Address - Fax:
Practice Address - Street 1:2621 DRYDEN RD STE 100
Practice Address - Street 2:
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439-1646
Practice Address - Country:US
Practice Address - Phone:937-281-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-18
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical