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General NPI Number Information
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NPI Number | 1780247247
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Entity Type | Individual
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Provider Name | MISTY M SMITH FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/19/2019
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 3101 BROADWAY BLVD
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City | KANSAS CITY
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State | MO
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Zip | 64111-2659
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Country | US
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Telephone | 816-234-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 6248 W 123RD ST
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City | OVERLAND PARK
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State | KS
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Zip | 66209-2716
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Country | US
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Telephone | 913-961-3678
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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 | 53-78549-072
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License Number State | KS
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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 | 2018043983
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License Number State | MO
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