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General NPI Number Information
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NPI Number | 1730425307
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Entity Type | Individual
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Provider Name | BRENDA GAYLE SMITH PMHCNS-BC, APRN/BC
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Gender | Female
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Dates
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Enumeration Date | 12/29/2012
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Last Update Date | 12/29/2012
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Provider Practice Location Address
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Address Line | 20 HAWKINS ST APT G
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City | DAHLONEGA
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State | GA
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Zip | 30533-1154
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Country | US
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Telephone | 706-974-5968
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Fax |
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Provider Business Mailing Address
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Address Line | 20 HAWKINS ST APT G
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City | DAHLONEGA
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State | GA
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Zip | 30533-1154
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Country | US
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Telephone | 706-974-5968
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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 | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | RN185152
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License Number State | GA
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