Provider Demographics
NPI:1164277505
Name:SMITH, KAYLIN (LMA)
Entity Type:Individual
Prefix:
First Name:KAYLIN
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2583 HOLLEY FERRY RD
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29070-9164
Mailing Address - Country:US
Mailing Address - Phone:803-687-2313
Mailing Address - Fax:
Practice Address - Street 1:2583 HOLLEY FERRY RD
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:SC
Practice Address - Zip Code:29070-9164
Practice Address - Country:US
Practice Address - Phone:803-687-2313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLMA-0145176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife