Individual
TARA D SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,FNP-C, PMHNP-BC
Contact information
Practice address
1900 TEBEAU ST, WAYCROSS, GA 31501-6357
(912) 338-6338
Mailing address
724 PINE NEEDLE RD, DOUGLAS, GA 31535-6512
(912) 327-0263
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RN213039
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN213039
GA
Other
Enumeration date
08/03/2015
Last updated
10/08/2025
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