Provider Demographics
NPI:1326536988
Name:SMITH, KAYLA DANIELLE (PHARM D)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:DANIELLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 SAM WALTON DR
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-8810
Mailing Address - Country:US
Mailing Address - Phone:931-738-3340
Mailing Address - Fax:931-738-8548
Practice Address - Street 1:202 SAM WALTON DR
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-8810
Practice Address - Country:US
Practice Address - Phone:931-738-3340
Practice Address - Fax:931-738-8548
Is Sole Proprietor?:No
Enumeration Date:2018-04-28
Last Update Date:2018-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39027183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist