Healthcare Provider Details

I. General information

NPI: 1962157842
Provider Name (Legal Business Name): MEGAN SMITH OXFORD APRN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS MEGAN LEIGH SMITH

II. Dates (important events)

Enumeration Date: 02/18/2022
Last Update Date: 03/11/2022
Certification Date: 03/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 DEWITT DR
LUGOFF SC
29078-9069
US

IV. Provider business mailing address

PO BOX 935722
ATLANTA GA
31193-5722
US

V. Phone/Fax

Practice location:
  • Phone: 803-438-1806
  • Fax:
Mailing address:
  • Phone: 843-792-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number25788
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: