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General NPI Number Information
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NPI Number | 1447922349
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Entity Type | Individual
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Provider Name | GABRIELLE ARYADNI SMITH PA
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Gender | Female
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Dates
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Enumeration Date | 09/29/2021
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 2300 CAMP CREEK PKWY
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City | ATLANTA
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State | GA
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Zip | 30337-3304
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Country | US
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Telephone | 678-666-4088
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Fax |
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Provider Business Mailing Address
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Address Line | 385 LAVA LN
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City | UNION CITY
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State | GA
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Zip | 30291-5188
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Country | US
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Telephone | 404-719-3099
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State | GA
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