Individual
KATHRYN MAE SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-6665
(937) 395-6668
Mailing address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-6665
(937) 395-6668
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
14097
OH
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.CNP.14097
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0082730
—
OH
05
—
201199110
—
IN
Enumeration date
04/05/2013
Last updated
04/01/2025
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