# KATHLEEN A SMERKO PMHNP-BC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558740548
- **Authorized official:** KATHLEEN ANN SMERKO MS., PSY NP., BC. (SOLE PROPRIETER)
- **Authorized official phone:** (602) 235-9505

## Contact information

- **Practice address:** 1121 E MISSOURI AVE STE 104, PHOENIX, AZ 85014-2723
- **Practice address phone:** (602) 235-9506
- **Practice address fax:** (602) 235-9506
- **Mailing address:** 1121 E MISSOURI AVE STE 104, PHOENIX, AZ 85014-2723
- **Mailing address phone:** (602) 235-9506
- **Mailing address fax:** (602) 235-9506

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | RN071540 | AZ | Yes |

## Other

- **Enumeration date:** 05/22/2015
- **Last updated:** 05/22/2015