Provider Demographics
NPI:1124908868
Name:SMITH, LAUREN REESE
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:REESE
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 1:485 SMITH VAUGHT SPUR
Mailing Address - Street 2:
Mailing Address - City:EUBANK
Mailing Address - State:KY
Mailing Address - Zip Code:42567-8631
Mailing Address - Country:US
Mailing Address - Phone:606-492-0236
Mailing Address - Fax:
Practice Address - Street 1:326 S MARTIN LUTHER KING BLVD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40526-2009
Practice Address - Country:US
Practice Address - Phone:859-257-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program