Lily Eliza Smith, | |
5722 Cabin Creek Rd, Dawes, WV 25054-7700 | |
(304) 595-5006 | |
Not Available |
Full Name | Lily Eliza Smith |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 5722 Cabin Creek Rd, Dawes, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1356011506 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 110721 (West Virginia) | Primary |
Entity Name | Cabin Creek Health Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366495525 PECOS PAC ID: 2466431101 Enrollment ID: O20130905000096 |
Mailing Address | Practice Location Address |
---|---|
Lily Eliza Smith, 5651 Walden Dr, Lake View, NY 14085-9744 Ph: (716) 359-5373 | Lily Eliza Smith, 5722 Cabin Creek Rd, Dawes, WV 25054-7700 Ph: (304) 595-5006 |
Kelli Jo Hupp, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5722 Cabin Creek Rd, Dawes, WV 25054 Phone: 304-595-5006 Fax: 304-595-5007 | |
Alexandra Ritchie, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5722 Cabin Creek Rd, Dawes, WV 25054 Phone: 304-595-5006 | |
Byron Menking Hoggatt, RN, CFNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5722 Cabin Creek Road, Dawes, WV 25054 Phone: 304-595-5006 Fax: 304-595-5007 | |
Tiffany Hughes, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5722 Cabin Creek Road, Dawes, WV 25054 Phone: 304-595-5006 Fax: 304-595-5007 |