MEDICARE: MRS. KELLI ANN SMITH

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	372600000X	Adult Companion
2	3747P1801X	Personal Care Attendant
3	372500000X	Chore Provider

General Provider Information

NPI Number	:	1760313084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KELLI ANN SMITH

Provider Business Mailing Address
First Line	:	417 S POPLAR ST
Second Line	:
City	:	NORTH PLATTE
State	:	NE
Zip	:	69101-5637
Country	:	US
Telephone Number	:	308-660-3944
Fax Number	:

Provider Business Practice Location Address
First Line	:	417 S POPLAR ST
Second Line	:
City	:	NORTH PLATTE
State	:	NE
Zip	:	69101-5637
Country	:	US
Telephone Number	:	308-660-3944
Fax Number	:

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

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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Directions to “ MRS. KELLI ANN SMITH ” Practice Location

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