David Cruse Smith, NREMT-B,LPN

Key facts

NPI

1659522142

Entity type

Individual (NPI type 1)

Primary specialty

Licensed Vocational Nurse 164X00000X

License

5066 (AK)

Practice address

436TH & 5TH Ted Stevens Way
Kotzebue, AK 99752-0758

Phone

(907) 442-2189

NPI assigned

Oct 2, 2008

Sex

Male

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

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 2, 2008.

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222905600000",
    "number": "1659522142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "997520043",
            "telephone_number": "907-442-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436TH & 5TH TED STEVENS WAY",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "997520758",
            "telephone_number": "907-442-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DAVID",
        "middle_name": "CRUSE",
        "credential": "NREMT-B,LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-02",
        "last_updated": "2008-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "AK",
            "license": "5066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kotzebue, AK

• Lisa C Shindler, PA-C
• Yvette Elizabeth Shoulders, LMSW
• Julia Sicilia, M.D.
• Hilda Skin, RHSI
• Harriette Slwooko
• Julia V Smith
• Kaelin Smith
• Margaret Smith, BSHS
• Marlene Rae Smith, RN
• Rachel Smith, LMSW

All providers in Kotzebue, AK · Licensed Vocational Nurse in Alaska