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General NPI Number Information
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NPI Number | 1093537656
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Entity Type | Individual
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Provider Name | KELSIE SMITH RN
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Gender | Female
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Dates
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Enumeration Date | 10/25/2024
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 550 N HILLSIDE ST
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City | WICHITA
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State | KS
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Zip | 67214-4976
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Country | US
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Telephone | 316-360-2054
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 E ZACHARY DR
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City | DERBY
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State | KS
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Zip | 67037-8989
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Country | US
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Telephone | 620-430-0391
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | TMP-163445
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 163WX0002X
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Taxonomy Name | High-Risk Obstetric Registered Nurse
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License Number | 132473
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License Number State | KS
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