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General NPI Number Information
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NPI Number | 1598306037
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Entity Type | Individual
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Provider Name | KAITLYN BROOKE SMITH NP
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Gender | Female
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Dates
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Enumeration Date | 10/07/2019
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 251 N LYERLY ST STE 100
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City | CHATTANOOGA
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State | TN
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Zip | 37404-2743
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Country | US
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Telephone | 423-826-8000
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Fax | 423-826-8005
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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Country | US
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Telephone |
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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 | 71012905A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 38161
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 903530
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License Number State | MS
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