Healthcare Provider Details

I. General information

NPI: 1013920909
Provider Name (Legal Business Name): HARLAN WAYNE SMITHER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 06/02/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E 14TH ST
SEDALIA MO
65301-5972
US

IV. Provider business mailing address

PO BOX 801128
KANSAS CITY MO
64180-1128
US

V. Phone/Fax

Practice location:
  • Phone: 660-826-8833
  • Fax: 660-827-3742
Mailing address:
  • Phone: 660-826-8833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number132663
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number132663
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: