Provider Demographics
NPI:1356760177
Name:SMITH, JOVAN RASHAAD (NURSES AIDE)
Entity type:Individual
Prefix:
First Name:JOVAN
Middle Name:RASHAAD
Last Name:SMITH
Suffix:
Gender:M
Credentials:NURSES AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1079 ZOPHI ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37216-3031
Mailing Address - Country:US
Mailing Address - Phone:901-247-3704
Mailing Address - Fax:859-997-1244
Practice Address - Street 1:1079 ZOPHI ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37216-3031
Practice Address - Country:US
Practice Address - Phone:615-857-2527
Practice Address - Fax:858-997-1244
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health