Provider Demographics
NPI:1871605907
Name:SMITH, KATE IRENE (APRN)
Entity type:Individual
Prefix:MRS
First Name:KATE
Middle Name:IRENE
Last Name:SMITH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 NILES RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06057-4229
Mailing Address - Country:US
Mailing Address - Phone:860-922-1432
Mailing Address - Fax:
Practice Address - Street 1:538 LITCHFIELD ST
Practice Address - Street 2:SUITE G-02
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-6669
Practice Address - Country:US
Practice Address - Phone:860-489-5068
Practice Address - Fax:860-489-3725
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003459363L00000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT003459OtherAPRN LICENSE