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General NPI Number Information
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NPI Number | 1588425326
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Entity Type | Individual
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Provider Name | NATHANIEL GARRETT SMITH CRNP
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Gender | Male
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Dates
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Enumeration Date | 01/18/2024
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 2660 10TH AVE S STE 528
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City | BIRMINGHAM
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State | AL
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Zip | 35205-1625
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Country | US
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Telephone | 205-933-9258
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Fax |
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Provider Business Mailing Address
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Address Line | 1206 INVERNESS COVE WAY
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City | HOOVER
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State | AL
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Zip | 35242-4261
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Country | US
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Telephone | 256-614-9365
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1-180176
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License Number State | AL
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