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Individual

KESLIE E SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
707 14TH ST, BARABOO, WI 53913-1539
(608) 252-8003
(608) 356-1554
Mailing address
707 14TH ST, BARABOO, WI 53913-1539
(608) 252-8003
(608) 356-1554

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
13664-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1568161404
WI
Enumeration date
02/28/2023
Last updated
09/07/2023
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