Individual
KATINA D SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
450 N NEW BALLAS RD STE 204, SAINT LOUIS, MO 63141-6836
(314) 991-0137
(314) 991-0603
Mailing address
PO BOX 840185, KANSAS CITY, MO 64184-0185
(314) 991-0137
(314) 991-0603
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2019015725
MO
363LG0600X
Gerontology Nurse Practitioner
2019015725
MO
Other
Enumeration date
05/18/2019
Last updated
12/21/2023
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