1366079881 NPI number — ASHLEY RENEE SMITH AGACNP-BC, MSN, BA

NPI Number: 1366079881
Health Care Provider/Practitioner: ASHLEY RENEE SMITH AGACNP-BC, MSN, BA

NPI Number : 1366079881 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1366079881",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SMITH",
    "FirstName": "ASHLEY",
    "MiddleName": "RENEE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "AGACNP-BC, MSN, BA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "YORK",
    "OtherFirstName": "ASHLEY",
    "OtherMiddleName": "RENEE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "3363 CONLEY DOWNS DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "POWDER SPRINGS",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30127-1197",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "404-819-6532",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "677 CHURCH ST NE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MARIETTA",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30060-1101",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "770-793-5000",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/25/2020",
    "LastUpdateDate": "09/04/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "163WC0200X",
          "TaxonomyName": "Critical Care Medicine Registered Nurse",
          "LicenseNumber": "RN222846",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2100X",
          "TaxonomyName": "Acute Care Nurse Practitioner",
          "LicenseNumber": "RN222846",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}