Provider Demographics
NPI:1871329359
Name:SMITH, BRIGGS NICOLE
Entity type:Individual
Prefix:
First Name:BRIGGS
Middle Name:NICOLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7417 BENTLEY PL
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8662
Mailing Address - Country:US
Mailing Address - Phone:614-364-1101
Mailing Address - Fax:
Practice Address - Street 1:1480 MANNING PKWY STE B
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7298
Practice Address - Country:US
Practice Address - Phone:614-888-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program