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Individual

MRS. KATLYN ANN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4 MEMORIAL DR STE 130, ALTON, IL 62002-6704
(618) 463-7600
Mailing address
4 MEMORIAL DR STE 130, ALTON, IL 62002-6704
(618) 463-7600

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085009225
MO
363A00000X
Physician Assistant
Primary
10004281A
IN
363A00000X
Physician Assistant
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1181613
NCCPA
Enumeration date
01/27/2021
Last updated
09/23/2025
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