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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. JOHNATHON CRAWFORD SMITH SR., CLPN

Active Sole Proprietor

MR. JOHNATHON CRAWFORD SMITH SR., CLPN is a Licensed Practical Nurse healthcare provider located in MANTACHIE, Mississippi. NPI 1275718660 is currently active in the NPPES registry. Verify at CMS.

Licensed Practical Nurse · MANTACHIE, MS

Registration Details

NPI Number
1275718660
Provider Type
Individual
Gender
Male
NPI Issued
Jan 3, 2008 (18.634106188249 yrs)
Last Updated
Jan 3, 2008
License
P231371 (MS)
Sole Proprietor
Yes

Practice Information

Address
165 BANKHEAD RD SW
MANTACHIE, MS, 388557267
Browse MS providers · Browse ZIP 38855
Phone
6628401944
Primary Specialty
Licensed Practical Nurse
164W00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.