Individual
KAITLYN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
765 ROUTE 10 E, STE 201, RANDOLPH, NJ 07869-1925
(973) 479-1128
Mailing address
105 RAIDER BLVD, SUITE 101, HILLSBOROUGH, NJ 08844-1528
(973) 479-1129
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ00498600
NJ
363LG0600X
Gerontology Nurse Practitioner
26NJ00498600
NJ
363LP2300X
Primary Care Nurse Practitioner
26NJ00498600
NJ
Other
Enumeration date
04/18/2014
Last updated
03/25/2015
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