Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 5012126 | NC |
NPI | 1023664026 |
---|---|
Provider Name | Dr. Kathryn Mckelvey Smith |
First Address | Greensboro, NC 27405-4522 |
Second Address | Greensboro, NC 27405-4522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2019 |
Last Update Date | 15/08/2019 |