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Individual
KATHLEEN MOREAU SMITH
Active
Individual
KATHLEEN MOREAU SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
F.N.P.
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP11751
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110039977
MEDICARE RAILROAD
CA
05
—
RN247089
—
CA
01
—
ZZZ34679Z
BLUE CROSS CALIFORNIA
CA
Enumeration date
08/13/2006
Last updated
07/07/2008
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