Healthcare Provider Details

I. General information

NPI: 1386303485
Provider Name (Legal Business Name): KAYLA KATHRYN LEAH SMITH CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHRYN LEAH SMITH RN

II. Dates (important events)

Enumeration Date: 12/16/2021
Last Update Date: 12/07/2022
Certification Date: 12/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 RED BANK ROAD
CINCINNATI OH
45221-3014
US

IV. Provider business mailing address

2139 AUBURN AVE
CINCINNATI OH
45219-2989
US

V. Phone/Fax

Practice location:
  • Phone: 513-272-0313
  • Fax: 513-272-0316
Mailing address:
  • Phone: 513-351-9900
  • Fax: 513-366-4491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0032569
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: