Smith, Kathleen W.

Smith, Kathleen W. is an individual health care provider with primary practice located at 900 Main Street Suite 280 , Peoria IL 61636-4688. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Smith, Kathleen W. can be contacted via phone (309) 643-6118.

Contact Information

Primary practice address
900 Main Street Suite 280 Peoria IL 61636-4688
Phone: (309) 643-6118
Fax: (309) 517-7476
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209.012013 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X 209012013 Illinois

Profile Details

NPI number 1992109755
LBN Legal business name Smith, Kathleen W.
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 22nd, 2014
Last updated Jul 25th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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