Individual
NICHOLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1505 W SHERMAN AVE, VINELAND, NJ 08360-7059
(856) 641-8000
Mailing address
11 SHADY LN, KENILWORTH, NJ 07033-1411
(908) 487-3482
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/02/2024
Last updated
10/12/2024
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