Individual
KIMBERLY DAWN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2030 LEWIS RD, HARRISBURG, IL 62946-4385
(618) 926-1401
Mailing address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
041376465
IL
Other
Enumeration date
03/28/2023
Last updated
03/28/2023
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