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Individual
VICTORIA RENERA-NISA SMITH
Active
Individual
VICTORIA RENERA-NISA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11179
NC
2251P0200X
Pediatric Physical Therapist
11179
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068UC
BCBS
NC
05
—
7212247
—
NC
Enumeration date
07/06/2007
Last updated
02/01/2023
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