Tiffany Smith
Individual provider Active NPI Community Health Worker · Genoa, WV
NPI 1013501725 · NPPES record last updated Feb 23, 2021
Key facts
- NPI
- 1013501725
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 33 Peach Rose LN
Genoa, WV 25517-7598 - Phone
- (304) 654-8907
- NPI assigned
- Feb 23, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
33 Peach Rose LN
Genoa, WV 25517-7598
Mailing address
89 Peach Rose LN
Genoa, WV 25517-7598
Phone (304) 654-8907
Other providers in Genoa, WV
- Trista Marie Pack
- Andrea Perry
- Jessica Louise Perry
- Kaitlyn Alexis Perry
- Julie Marie Shelton
- Lola Florence Swimm
- Carolyn Sue Thompson
- Lawrence Vance
- Christy Wheeler
- Amber Nicole Wilson
All providers in Genoa, WV · Community Health Worker in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.