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General NPI Number Information
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NPI Number | 1043517923
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Entity Type | Individual
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Provider Name | MARY KATHLENE SMITH-CRASE APN
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Gender | Female
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Dates
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Enumeration Date | 02/11/2011
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1501 S WALDRON RD STE 208
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City | FORT SMITH
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State | AR
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Zip | 72903-2565
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Country | US
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Telephone | 479-900-0976
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Fax | 833-954-4044
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Provider Business Mailing Address
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Address Line | 11501 HURON LN
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City | LITTLE ROCK
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State | AR
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Zip | 72211-1846
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Country | US
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Telephone | 501-904-4762
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | A003489
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | R0067810
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License Number State | OK
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