Individual
MRS. JILL M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4013 N RIDGE RD, STE 210, WICHITA, KS 67205-8860
(316) 945-7309
(316) 945-9131
Mailing address
7707 E CENTRAL AVE, LITTLE CLINIC CENTRAL & ROCK, WICHITA, KS 67206-2100
(316) 207-9640
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
45619
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200267830A
—
KS
Enumeration date
07/14/2005
Last updated
01/02/2018
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