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NPI Code Detail

MEDICARE: MS. ERIN RENEE SMITH FNP

MEDICARE: MS. ERIN RENEE SMITH FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner80869SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255333779
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ERIN RENEE SMITH FNP
Provider Business Mailing Address
First Line : 1309 YELLOWOOD CT
Second Line :
City : ROCK HILL
State : SC
Zip : 29732-8070
Country : US
Telephone Number : 803-329-6648
Fax Number : 803-985-4134
Provider Business Practice Location Address
First Line : 1147 EBENEZER RD
Second Line :
City : ROCK HILL
State : SC
Zip : 29732-2355
Country : US
Telephone Number : 803-329-6648
Fax Number : 803-985-4134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 06/27/2016

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