Antoine Smith, LPN
Individual provider Active NPI Licensed Practical Nurse · Waldorf, MD
NPI 1699554337 · NPPES record last updated Sep 22, 2023
Key facts
- NPI
- 1699554337
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- LP56157 (MD)
- Practice address
- 11100 Billingsley Rd
Waldorf, MD 20602-3400 - Phone
- (240) 754-6100
- NPI assigned
- Sep 22, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP56157 | MD | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 11100 Billingsley Road Opco LLC | Current |
Accepting new patients |
Locations
11100 Billingsley Rd
Waldorf, MD 20602
Phone (202) 849-5619
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LP56157 | MD | Yes |
Addresses
Primary practice location
11100 Billingsley Rd
Waldorf, MD 20602-3400
Mailing address
11100 Billingsley Rd
Waldorf, MD 20602-3400
Phone (240) 754-6100
Other providers in Waldorf, MD
- Candice Smart
- Smile Nest LLC
- Lauryn R. Smith-Winton
- Alexis Nicole Smith
- Alita-Geri Kiana Smith
- Chantel Smith
- Heaven Smith
- Joanna Goyette Smith
- Kellie Smith
- Linda E Smith
All providers in Waldorf, MD · Licensed Practical Nurse in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2023. 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.