Individual
KELLEE J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
311 S CLARK ST, CARROLL, IA 51401-3038
(712) 792-3581
(712) 792-2124
Mailing address
311 S CLARK ST, CARROLL, IA 51401-3038
(712) 792-3581
(712) 792-2124
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
111826
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0472183
—
IA
Enumeration date
01/13/2006
Last updated
12/13/2013
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