MEDICARE: SHERRY SUE SMILEY ARNP

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	363LF0000X	Family Nurse Practitioner	45075	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00057490	OTHER	KS	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	161060	OTHER	KS	BC/BS

General Provider Information

NPI Number	:	1881613016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRY SUE SMILEY ARNP

Provider Business Mailing Address
First Line	:	420 W 15TH AVE
Second Line	:	SUITE 301
City	:	EMPORIA
State	:	KS
Zip	:	66801-5367
Country	:	US
Telephone Number	:	620-343-2376
Fax Number	:	620-343-0095

Provider Business Practice Location Address
First Line	:	1301 W 12TH AVE
Second Line	:	SUITE 301
City	:	EMPORIA
State	:	KS
Zip	:	66801-2587
Country	:	US
Telephone Number	:	620-343-2376
Fax Number	:	620-343-0095

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	01/19/2017

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Directions to “ SHERRY SUE SMILEY ARNP” Practice Location

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