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General NPI Number Information
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NPI Number | 1215255971
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Entity Type | Individual
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Provider Name | ELIZABETH SMITH REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 05/05/2010
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 223 PERSON ST STE A
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-5733
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Country | US
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Telephone | 678-517-7775
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Fax | 910-483-7116
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Provider Business Mailing Address
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Address Line | 35 SAVANNAH CIR
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City | COVINGTON
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State | GA
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Zip | 30016-6653
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Country | US
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Telephone | 678-517-7775
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 126444
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 149819
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License Number State | NC
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