Doctor Name: | MRS. CHRYSTAL SMITH |
NPI Number: | 1245501592 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | RN172144 |
Business Practice Address: | 23 Westover Dr Nw Adairsville, GA - 301034656 |
Business Phone Number: | 7707737594 |
Business Fax Number: | |
Mailing Address: | 23 Westover Dr Nw, ADAIRSVILLE |
State: | GA |
Postal Code: | 301034656 |
Phone Number: | 7707737594 |
Fax Number: | |
NPI Enumeration Date: | 01/18/2012 |
NPI Last Update Date: | 01/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | RN172144 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |