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General NPI Number Information
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NPI Number | 1740140854
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Entity Type | Individual
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Provider Name | KEVIN RAY SMITH RN
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Gender | Male
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Dates
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Enumeration Date | 11/12/2025
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 837 EAGLE POINT DR
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32092-1069
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Country | US
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Telephone | 904-866-9449
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Fax |
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Provider Business Mailing Address
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Address Line | 3841 GREEN HILLS VILLAGE DR STE 200
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City | NASHVILLE
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State | TN
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Zip | 37215-2691
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN9521483
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 40829
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License Number State | TN
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