Provider Demographics
NPI:1447951819
Name:SMITH, LEONA M (CPD)
Entity type:Individual
Prefix:
First Name:LEONA
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:CPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 KENYON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-1436
Mailing Address - Country:US
Mailing Address - Phone:401-548-1584
Mailing Address - Fax:
Practice Address - Street 1:67 KENYON ST APT 1
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-1436
Practice Address - Country:US
Practice Address - Phone:401-548-1584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI201355374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula