Healthcare Provider Details

I. General information

NPI: 1407441132
Provider Name (Legal Business Name): GEORGEGTTE SHARI SMITH BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2021
Last Update Date: 01/08/2023
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7160 HODGSON MEMORIAL DR STE 103
SAVANNAH GA
31406-2563
US

IV. Provider business mailing address

PO BOX 261
TOWNSEND GA
31331-0261
US

V. Phone/Fax

Practice location:
  • Phone: 912-335-7383
  • Fax: 912-349-6608
Mailing address:
  • Phone: 912-399-3302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN288150
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: