MEDICARE: PAMELA SMITH APRN-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	363LF0000X	Family Nurse Practitioner	201576	NC
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	201576	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588655666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA SMITH APRN-C

Provider Business Mailing Address
First Line	:	350 PEE DEE AVE STE 101
Second Line	:
City	:	ALBEMARLE
State	:	NC
Zip	:	28001-4945
Country	:	US
Telephone Number	:	704-986-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 ASHVILLE AVE STE 200
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27518-8682
Country	:	US
Telephone Number	:	919-650-3325
Fax Number	:	919-651-8091

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

Provider Enumeration Date	:	10/29/2005
Last Update Date	:	01/25/2018

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Directions to “ PAMELA SMITH APRN-C” Practice Location

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