Healthcare Provider Details

I. General information

NPI: 1134823933
Provider Name (Legal Business Name): SIERRA ASHTON SMITH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12101 CAROL LN STE 101
FREDERICKSBURG VA
22407-6104
US

IV. Provider business mailing address

1340 CENTRAL PARK BLVD STE 100
FREDERICKSBURG VA
22401-4940
US

V. Phone/Fax

Practice location:
  • Phone: 540-741-9300
  • Fax: 540-741-9301
Mailing address:
  • Phone: 540-741-4254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberSMIT-K2LB3D
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101289271
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: