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General NPI Number Information
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NPI Number | 1841824232
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Entity Type | Individual
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Provider Name | ERICA SHEREE SMITH PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/25/2020
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 2011 23RD AVE
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City | MERIDIAN
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State | MS
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Zip | 39301-3110
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Country | US
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Telephone | 601-286-5983
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Fax |
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Provider Business Mailing Address
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Address Line | 4110 59TH PL
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City | MERIDIAN
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State | MS
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Zip | 39307-2917
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Country | US
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Telephone | 769-226-9272
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 905108
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 902395
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License Number State | MS
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