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Individual

LOGAN GARRETT SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA DNP

Contact information

Practice address
3901 RAINBOW BLVD, KANSAS CITY, KS 66160-8500
(913) 588-1227
Mailing address
6235 ASH ST, MISSION, KS 66205-3006

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
TMP-155002
KS
163WC0200X
Critical Care Medicine Registered Nurse
2011000224
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
TMP155006
KS

Other

Enumeration date
07/20/2017
Last updated
07/24/2017
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