Healthcare Provider Details

I. General information

NPI: 1487283156
Provider Name (Legal Business Name): KELSEY HAYES SMITH CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KELSEY PAIGE HAYES RN

II. Dates (important events)

Enumeration Date: 04/05/2020
Last Update Date: 02/01/2024
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 6TH AVE S
BIRMINGHAM AL
35233-1932
US

IV. Provider business mailing address

10 13TH ST S APT 2131
BIRMINGHAM AL
35233-1333
US

V. Phone/Fax

Practice location:
  • Phone: 256-393-2348
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number1-167989
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1-167989
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: