Lynette S Smith, PHD, PMHNP, FNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3007259 Issued in KY

Practice address

2642 Chandler Dr Apt 1814
Bowling Green, KY 42104-6257

Phone

(812) 021-0222

NPI assigned

Jul 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1336165232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2642 CHANDLER DR APT 1814",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421046257",
            "telephone_number": "812-201-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2642 CHANDLER DR APT 1814",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421046257",
            "telephone_number": "812-021-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LYNETTE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PHD, PMHNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3007259",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007259",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000543710",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200334480A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla J. Smith, DNP, APRN, FNP-BC
• Kimberly Jean Smith, M.S. CCC-SLP
• Kirsti Elaine Smith, PT, DPT
• Kyle Smith, M.D.
• Ladonna Sharon Smith, MD
• Marilyn C Smith
• McPherson Smith
• Megan Smith
• Mercedes Breyanna Smith
• Michael Smith, KCSA

• Psychiatric/Mental Health Nurse Practitioner in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.