Individual
KELLY WAYNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP FNP-PP
Contact information
Practice address
BAY CLINIC, LLP, 1750 THOMPSON RD, COOS BAY, OR 97420
(541) 269-0333
Mailing address
BAY CLINIC, LLP, 1750 THOMPSON RD, COOS BAY, OR 97420
(541) 269-0333
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
OR
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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