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General NPI Number Information
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NPI Number | 1699253294
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Entity Type | Individual
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Provider Name | GREGORY SMITH FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 08/06/2018
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 3505 PELHAM RD STE B
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City | GREENVILLE
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State | SC
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Zip | 29615-4154
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Country | US
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Telephone | 864-551-8022
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Fax | 864-412-1003
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Provider Business Mailing Address
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Address Line | 3505 PELHAM RD STE B
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City | GREENVILLE
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State | SC
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Zip | 29615-4154
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Country | US
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Telephone | 864-551-8022
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Fax | 864-412-1003
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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 | 71010511A
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License Number State | IN
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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 | 21993
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 21993
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License Number State | SC
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