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General NPI Number Information
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NPI Number | 1881695419
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Entity Type | Individual
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Provider Name | WANDA JONES SMITH FNP
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Gender | Female
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Dates
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Enumeration Date | 08/04/2005
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 2334 41ST ST STE 225
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City | WILMINGTON
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State | NC
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Zip | 28403-5502
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Country | US
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Telephone | 910-815-3122
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Fax |
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Provider Business Mailing Address
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Address Line | 2334 41ST ST STE 225
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City | WILMINGTON
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State | NC
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Zip | 28403-5502
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Country | US
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Telephone | 910-815-3122
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 201284
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License Number State | NC
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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 | 201284
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License Number State | NC
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