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Individual

TRAVIS L SMITH

Active
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Individual

TRAVIS L SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3004523
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200946180
IN
05
74009473
KY
Enumeration date
12/29/2005
Last updated
11/12/2024
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