Healthcare Provider Details

I. General information

NPI: 1831831478
Provider Name (Legal Business Name): MAKAYLA DANIELLE SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BURKESVILLE RD
ALBANY KY
42602-1604
US

IV. Provider business mailing address

250 BURKESVILLE RD
ALBANY KY
42602-1604
US

V. Phone/Fax

Practice location:
  • Phone: 606-387-0323
  • Fax: 606-387-0310
Mailing address:
  • Phone: 606-387-0323
  • Fax: 606-387-0310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number1161518
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3018320
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: