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General NPI Number Information
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NPI Number | 1053083600
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Entity Type | Individual
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Provider Name | KAITLIN S SMITH CPNP
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Gender | Female
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Dates
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Enumeration Date | 10/01/2021
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 7333 E THOMAS RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-7215
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Country | US
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Telephone | 480-585-5200
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Fax | 480-585-5233
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Provider Business Mailing Address
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Address Line | 7010 E CHAUNCEY LN STE 225
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City | PHOENIX
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State | AZ
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Zip | 85054-3117
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Country | US
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Telephone | 480-585-5200
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Fax | 480-585-5233
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 276788
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License Number State | AZ
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