Individual
YATEMIESE SMART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
250 BRAY ST, ATHENS, GA 30601-2203
(706) 389-6789
Mailing address
295 HIGHLAND PARK DR, ATHENS, GA 30605-3579
(706) 202-1740
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2995633
GA
Other
Enumeration date
04/01/2022
Last updated
04/01/2022
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