Gwyndolen Smith, LPN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

LP042073 Issued in AZ

Practice address

711 E Missouri Ave Ste 100
Phoenix, AZ 85014-2811

Phone

(602) 433-1200

NPI assigned

Dec 10, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1053786459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15620 N 55TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063038",
            "telephone_number": "602-314-6036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 E MISSOURI AVE STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142811",
            "telephone_number": "602-433-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GWYNDOLEN",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-10",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "AZ",
            "license": "LP042073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina M Smith
• Gregory C Smith, PHARM.D.
• Gregory Ryan Smith, MSOT, OTR/L
• Gregory T Smith, D.D.S.
• Gwenneth P. Smith, P.T.
• Harriet J Smith, PHD
• Herman Bradley Smith, MD
• Jack Steven Smith, DC
• Jade Smith, OTD, OTR/L
• Jala Latrice Nicole Smith

• Licensed Vocational Nurse in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Licensed Vocational Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.