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NPI Code Detail

MEDICARE: KAYLA KRASHELL SMITH RD

MEDICARE: KAYLA KRASHELL SMITH RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianDX3590MD

General Provider Information

NPI Number : 1457850679
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA KRASHELL SMITH RD
Provider Business Mailing Address
First Line : 1001 SPRING ST
Second Line :
City : SILVER SPRING
State : MD
Zip : 20910-4022
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1001 SPRING ST
Second Line :
City : SILVER SPRING
State : MD
Zip : 20910-4022
Country : US
Telephone Number : 740-424-1175
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2018
Last Update Date : 02/02/2018

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Directions to “ KAYLA KRASHELL SMITH RD” Practice Location

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