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General NPI Number Information
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NPI Number | 1982378139
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Entity Type | Individual
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Provider Name | KIMBERLY LYNNE SMITH RN BSN IBCLC
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Gender | Female
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 2107 E WILLIS RD
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City | GILBERT
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State | AZ
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Zip | 85297-2089
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Country | US
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Telephone | 480-586-8541
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Fax |
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Provider Business Mailing Address
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Address Line | 2107 E WILLIS RD
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City | GILBERT
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State | AZ
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Zip | 85297-2089
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Country | US
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Telephone | 480-586-8541
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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 | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | 227329
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | L-303739
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License Number State | AZ
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