Provider Demographics
NPI:1699066464
Name:SMITH, JALAYNA ASHLEY (MD)
Entity type:Individual
Prefix:DR
First Name:JALAYNA
Middle Name:ASHLEY
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:JALAYNA
Other - Middle Name:ASHLEY
Other - Last Name:RICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 CENTURY AVE SE
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-3108
Mailing Address - Country:US
Mailing Address - Phone:320-587-2020
Mailing Address - Fax:
Practice Address - Street 1:3 CENTURY AVE SE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-3108
Practice Address - Country:US
Practice Address - Phone:320-587-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN56002207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine