Provider Demographics
NPI:1801770839
Name:SMITH, DENEICE M
Entity type:Individual
Prefix:MRS
First Name:DENEICE
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DENEICE
Other - Middle Name:M
Other - Last Name:LEATHERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 S JOHNSON RD APT 627
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-6533
Mailing Address - Country:US
Mailing Address - Phone:812-215-0814
Mailing Address - Fax:812-215-0814
Practice Address - Street 1:550 S JOHNSON RD APT 627
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-6533
Practice Address - Country:US
Practice Address - Phone:812-215-0814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant