MEDICARE: JUSTINE ANN SMITH MSN, APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC1500X	Community Health Registered Nurse	574776	PA
2	363LF0000X	Family Nurse Practitioner	SP027667	PA

General Provider Information

NPI Number	:	1356973549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTINE ANN SMITH MSN, APRN, FNP-C

Provider Business Mailing Address
First Line	:	1533 COMMERCE AVE STE 2
Second Line	:
City	:	CARLISLE
State	:	PA
Zip	:	17015-9128
Country	:	US
Telephone Number	:	717-960-8956
Fax Number	:	717-218-7557

Provider Business Practice Location Address
First Line	:	1533 COMMERCE AVE STE 2
Second Line	:
City	:	CARLISLE
State	:	PA
Zip	:	17015-9128
Country	:	US
Telephone Number	:	717-960-8956
Fax Number	:	717-218-7557

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2020
Last Update Date	:	06/04/2025

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