| Doctor Name: | SHELLY P SMITH |
| NPI Number: | 1417911843 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | A.N.P. |
| License Number: | 0024164980 |
| Business Practice Address: | 3452 Anderson Hwy Suite D Powhatan, VA - 231395845 |
| Business Phone Number: | 8042856050 |
| Business Fax Number: | 8045982481 |
| Mailing Address: | 3452 Anderson Hwy, Suite D POWHATAN |
| State: | VA |
| Postal Code: | 231395845 |
| Phone Number: | 8042856050 |
| Fax Number: | 8045982481 |
| NPI Enumeration Date: | 04/13/2006 |
| NPI Last Update Date: | 04/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 0024164980 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |