Healthcare Provider Details

I. General information

NPI: 1417535303
Provider Name (Legal Business Name): KATELYNN SMITH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DR
CHAPEL HILL NC
27514-4226
US

IV. Provider business mailing address

101 MANNING DR
CHAPEL HILL NC
27514-4226
US

V. Phone/Fax

Practice location:
  • Phone: 849-741-1000
  • Fax:
Mailing address:
  • Phone: 984-974-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2026-04118
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: