Individual
MRS. MANDESA MALIKA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
4300 FAYETTEVILLE RD, LUMBERTON, NC 28358
(910) 608-3078
(910) 608-3079
Mailing address
5221 PARAMOUNT PKWY STE 220, MORRISVILLE, NC 27560-5490
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
249148
NC
367A00000X
Advanced Practice Midwife
573
NC
367A00000X
Advanced Practice Midwife
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
573
LICENSE NUMBER
NC
Enumeration date
07/24/2015
Last updated
12/11/2024
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