Individual
JAMISHA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
228 BROADMOOR DR, RAYMORE, MO 64083-9298
(816) 974-2974
Mailing address
228 BROADMOOR DR, RAYMORE, MO 64083-9298
(816) 974-2974
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2014024403
MO
164W00000X
Licensed Practical Nurse
24-45787-071
KS
Other
Enumeration date
09/15/2014
Last updated
09/15/2014
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