Provider Demographics
NPI:1619766359
Name:SMILEY, KIRA ANGELA (PA-C)
Entity type:Individual
Prefix:
First Name:KIRA
Middle Name:ANGELA
Last Name:SMILEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18022 PRIORY LN
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-2424
Mailing Address - Country:US
Mailing Address - Phone:612-889-9558
Mailing Address - Fax:
Practice Address - Street 1:18022 PRIORY LN
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-2424
Practice Address - Country:US
Practice Address - Phone:612-889-9558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant