Provider Demographics
NPI:1194024513
Name:SMITH, MIIAH NAJA (CERTIFICATED NURSE A)
Entity Type:Individual
Prefix:MRS
First Name:MIIAH
Middle Name:NAJA
Last Name:SMITH
Suffix:
Gender:F
Credentials:CERTIFICATED NURSE A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 171421
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66117-0421
Mailing Address - Country:US
Mailing Address - Phone:913-307-6785
Mailing Address - Fax:
Practice Address - Street 1:807 N 5TH STREET #A
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66101-2441
Practice Address - Country:US
Practice Address - Phone:913-307-6785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS161737163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse