Individual
KIMBERLY RENEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
4101 TECHNOLOGY AVE, NEW ALBANY, IN 47150-8548
(812) 941-4500
Mailing address
4101 TECHNOLOGY AVE, NEW ALBANY, IN 47150-8548
(812) 941-4500
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10000921
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00924294
RAILROAD MEDICARE PTAN
IN
Enumeration date
11/09/2006
Last updated
03/29/2021
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