Individual ProviderKatie L SmithNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2808 Martin Luther King Jr Blvd, Panama City, FL 32405-4410(315) 800-3213PECOS EnrollmentBased on the most recent information from CMS, provider Katie L Smith does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1902445679Provider TypeIndividualFull NameSmith, Katie LCredentialAPRNGenderFemaleSole ProprietorYesEnumeration Date12/30/2019Last Updated9/4/2024Contact InformationPractice LocationPractice Address2808 Martin Luther King Jr Blvd, Panama City, FL 32405-4410Phone(315) 800-3213Fax(301) 238-7842Mailing LocationMailing Address2808 Martin Luther King Jr Blvd, Panama City, FL 32405-4410Phone(315) 800-3213Fax(301) 238-7842Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN11005940FloridaCode367A00000XDescriptionAdvanced Practice MidwifePhysician Assistants & Advanced Practice Nursing ProvidersLicense590699New YorkCode367A00000XDescriptionAdvanced Practice MidwifePhysician Assistants & Advanced Practice Nursing ProvidersLicenseRN298822GeorgiaCode367A00000XDescriptionAdvanced Practice MidwifePhysician Assistants & Advanced Practice Nursing ProvidersLicense11005940Florida