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Individual

KELLY LYNN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1999 WABASH AVE, SPRINGFIELD, IL 62704-5351
(217) 523-2273
(217) 523-2272
Mailing address
1999 WABASH AVE, SPRINGFIELD, IL 62704-5351
(217) 523-2273
(217) 523-2272

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041289431
IL

Other

Enumeration date
01/15/2016
Last updated
01/15/2016
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