Individual
KATHLEEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 CHANNELSIDE WALK WAY APT 1438, TAMPA, FL 33602-6741
(301) 873-2636
Mailing address
601 CHANNELSIDE WALK WAY APT 1438, TAMPA, FL 33602-6741
(301) 873-2636
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
11007226
FL
363LP2300X
Primary Care Nurse Practitioner
LP-0000320
DE
Other
Enumeration date
08/19/2019
Last updated
08/13/2020
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