Individual
KYRIE I'SHANAE NICOLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MEDICAL ASSISTANT
Contact information
Practice address
1341 N ESCONDIDO BLVD, ESCONDIDO, CA 92026-2507
(866) 760-7877
Mailing address
6262 BEADNELL WAY APT 1L, SAN DIEGO, CA 92117-4149
(216) 538-8410
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
05/25/2023
Last updated
06/06/2023
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