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General NPI Number Information
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NPI Number | 1073724555
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Entity Type | Individual
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Provider Name | KAREN JEANETTE SMITH CRNP
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Gender | Female
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 2996 E HIGHWAY 501
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City | CONWAY
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State | SC
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Zip | 29526-9532
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Country | US
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Telephone | 843-347-2613
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Fax |
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Provider Business Mailing Address
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Address Line | 2996 E HIGHWAY 501
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City | CONWAY
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State | SC
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Zip | 29526-9532
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R195149
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP008367
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 27945
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License Number State | SC
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