Healthcare Provider Details

I. General information

NPI: 1093647661
Provider Name (Legal Business Name): ASHLYN SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 DIAMOND PKWY STE 200
NORTH KANSAS CITY MO
64116-4329
US

IV. Provider business mailing address

9806 E 219TH CIR
PECULIAR MO
64078-8533
US

V. Phone/Fax

Practice location:
  • Phone: 816-842-6717
  • Fax:
Mailing address:
  • Phone: 913-689-8198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2026023507
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: