Individual
MRS. KATHERINE TERESA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
17201 WRIGHT STREET, SUITE 200, OMAHA, NE 68130
(402) 334-4773
(402) 330-7463
Mailing address
17445 ARBOR STREET, SUITE 310, OMAHA, NE 68130
(402) 572-3535
(402) 572-2688
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1301
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1301
PA LICENSE
NE
Enumeration date
02/05/2007
Last updated
11/14/2024
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