Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | SP015718 | PA |
NPI | 1033575451 |
---|---|
Provider Name | Kayla Sarah Faith Smith |
First Address | Allentown, PA 18104-2307 |
Second Address | Allentown, PA 18104-2307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2016 |
Last Update Date | 14/01/2016 |