Individual
MRS. LISA DIAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1806 LEE AVE, TIFTON, GA 31794-3639
(229) 386-1528
(229) 388-0556
Mailing address
1806 LEE AVE, TIFTON, GA 31794-3639
(229) 386-1528
(229) 388-0556
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN176448
GA
Other
Enumeration date
09/04/2013
Last updated
09/04/2013
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