Individual
MARY ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2306 ALEXANDRIA PIKE, SOUTHGATE, KY 41071-3234
(589) 816-0775
Mailing address
101 JEROME CT, COLD SPRING, KY 41076-3522
(859) 781-6273
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
3010988
KY
Other
Enumeration date
11/09/2017
Last updated
11/09/2017
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