Individual
KATHLEEN J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
333 COTTMAN AVE, MEDICAL STAFF OFFICE/ENROLLMENT, PHILADELPHIA, PA 19111
(215) 728-2500
(215) 728-3639
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 728-6900
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP011754
PA
Other
Enumeration date
11/03/2011
Last updated
06/06/2018
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