Provider Demographics
NPI:1861225278
Name:SMOOT, JO ELAINE (WHNP-BC)
Entity type:Individual
Prefix:
First Name:JO ELAINE
Middle Name:
Last Name:SMOOT
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 W NORTH AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15233-1911
Mailing Address - Country:US
Mailing Address - Phone:412-592-8617
Mailing Address - Fax:
Practice Address - Street 1:1110 W NORTH AVE APT 2
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15233-1911
Practice Address - Country:US
Practice Address - Phone:412-592-8617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP030426363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health