Individual
KELLI SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
219 MAIN ST, WAYNE, NE 68787-1924
(402) 375-5741
(402) 375-3879
Mailing address
219 MAIN ST, WAYNE, NE 68787-1924
(402) 375-5741
(402) 375-3879
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470746990
—
NE
Enumeration date
05/25/2016
Last updated
05/25/2016
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