MEDICARE: KELSEY ANNE SMITH NP

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	363L00000X	Nurse Practitioner	5006235	NC

General Provider Information

NPI Number	:	1386083210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY ANNE SMITH NP

Provider Business Mailing Address
First Line	:	PO BOX 935983
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31193-5983
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1213 LEXINGTON AVE STE B
Second Line	:
City	:	THOMASVILLE
State	:	NC
Zip	:	27360-3416
Country	:	US
Telephone Number	:	336-481-1950
Fax Number	:

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

Provider Enumeration Date	:	06/25/2013
Last Update Date	:	12/24/2025

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