Healthcare Provider Details

I. General information

NPI: 1740833144
Provider Name (Legal Business Name): KATELYN ELIZABETH KREKE SMITH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2019
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 NORTHLAND BLVD
CINCINNATI OH
45240-3248
US

IV. Provider business mailing address

300 HIGH ST FL 4
HAMILTON OH
45011-6078
US

V. Phone/Fax

Practice location:
  • Phone: 513-941-4999
  • Fax:
Mailing address:
  • Phone: 513-454-1460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.025183
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: