Individual
MATTHEW SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
9100 W 74TH ST, SHAWNEE, KS 66204-4004
(913) 632-2230
(913) 748-9319
Mailing address
PO BOX 411895 DEPT 109, KANSAS CITY, MO 64141
(913) 642-4900
(913) 381-0979
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
140612
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
557553
KS
Other
Enumeration date
10/23/2017
Last updated
03/17/2018
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