Individual
MS. KATHRYN BRUNK SMILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4070
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4070
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-03567
NC
363A00000X
Physician Assistant
PA9104473
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01139562
—
MS
05
—
1285805499
—
NC
05
—
1460PA
—
SC
05
—
2141141
—
LA
05
—
8102554
—
NC
Enumeration date
03/14/2008
Last updated
07/22/2016
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