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Individual

MRS. KELLY JEAN SMART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
215 GLASGOW ST, CLYDE, NY 14433-1222
(315) 902-3020
(315) 923-7906
Mailing address
215 GLASGOW ST, CLYDE, NY 14433-1222
(315) 902-3020
(315) 923-7906

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
532167-1
NY

Other

Enumeration date
08/26/2015
Last updated
08/26/2015
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