Provider Demographics
NPI:1578802203
Name:SMITH, KAFILAT A
Entity Type:Individual
Prefix:
First Name:KAFILAT
Middle Name:A
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5024 TOWNSEND WAY APT B3
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1876
Mailing Address - Country:US
Mailing Address - Phone:301-404-6708
Mailing Address - Fax:
Practice Address - Street 1:5024 TOWNSEND WAY APT B3
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-1876
Practice Address - Country:US
Practice Address - Phone:301-404-6708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide