Healthcare Provider Details

I. General information

NPI: 1508707571
Provider Name (Legal Business Name): THE SMART CARE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 AVALON CIR STE B
BRANDON MS
39047-7920
US

IV. Provider business mailing address

1814 ST JOHN RD
BRAXTON MS
39044-9470
US

V. Phone/Fax

Practice location:
  • Phone: 601-675-2409
  • Fax: 601-893-5392
Mailing address:
  • Phone: 601-675-2409
  • Fax: 601-893-5392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER DARLENE SMITH
Title or Position: APRN
Credential: FPMHNP-BC
Phone: 601-906-3857