Provider Demographics
NPI:1669540357
Name:SMITH, VADSANA K (APRN)
Entity type:Individual
Prefix:
First Name:VADSANA
Middle Name:K
Last Name:SMITH
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:VADSANA
Other - Middle Name:K
Other - Last Name:KHAMPHAKDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:5100 W 110TH ST STE 120
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1215
Mailing Address - Country:US
Mailing Address - Phone:913-234-7600
Mailing Address - Fax:816-361-5775
Practice Address - Street 1:19550 E 39TH ST S STE 227
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2358
Practice Address - Country:US
Practice Address - Phone:913-234-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-45830-102363L00000X
MO2011025324363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner