Individual
KATHERINE ELLEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-C
Contact information
Practice address
736 IRVING AVE # 9100, SYRACUSE, NY 13210-1687
(315) 470-7379
Mailing address
100 ROCKFORD DR, SYRACUSE, NY 13224-1828
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
383131
NY
Other
Enumeration date
06/11/2020
Last updated
06/11/2020
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