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General NPI Number Information
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NPI Number | 1487436770
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Entity Type | Individual
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Provider Name | KAYLA SMITH FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/20/2023
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 2855 MILLER DR STE 205
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City | PLYMOUTH
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State | IN
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Zip | 46563-8093
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Country | US
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Telephone | 260-267-8489
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Fax | 844-909-4798
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Provider Business Mailing Address
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Address Line | 58071 COUNTY ROAD 23
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City | GOSHEN
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State | IN
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Zip | 46528-7722
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Country | US
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Telephone | 260-267-8489
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Fax | 844-909-4798
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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 | 28246371A
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License Number State | IN
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