Healthcare Provider Details

I. General information

NPI: 1881432854
Provider Name (Legal Business Name): RASHEDA GABRIELLE SMITH FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2024
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 LANCASTER ST SW STE 10
AIKEN SC
29801-3770
US

IV. Provider business mailing address

105 LANCASTER ST SW STE 10
AIKEN SC
29801-3770
US

V. Phone/Fax

Practice location:
  • Phone: 803-598-3578
  • Fax: 803-598-3579
Mailing address:
  • Phone: 803-598-3578
  • Fax: 803-598-3579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number29025
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: