MEDICARE: TRISHA LOUISE SMITH RN

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
1	163W00000X	Registered Nurse	13-107788-101	KS

General Provider Information

NPI Number	:	1659245520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRISHA LOUISE SMITH RN

Provider Business Mailing Address
First Line	:	817A ARGYLE AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	KS
Zip	:	67467-1621
Country	:	US
Telephone Number	:	785-392-2822
Fax Number	:	785-392-3640

Provider Business Practice Location Address
First Line	:	817A ARGYLE AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	KS
Zip	:	67467-1621
Country	:	US
Telephone Number	:	785-392-2822
Fax Number	:	785-392-3640

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2025
Last Update Date	:	10/02/2025

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