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General NPI Number Information
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NPI Number | 1902720675
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Entity Type | Individual
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Provider Name | KATELYN SMITH PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 93 E CROY ST
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City | HAILEY
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State | ID
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Zip | 83333-8407
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Country | US
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Telephone | 208-788-9714
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Fax |
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Provider Business Mailing Address
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Address Line | 1521 WOODSIDE BLVD
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City | HAILEY
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State | ID
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Zip | 83333-8850
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Country | US
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Telephone | 208-788-9714
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 1581321
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License Number State | ID
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