Individual
LISA CUNNINGHAM SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
65 INTERNATIONAL DR, GREENVILLE, SC 29615-4816
(864) 987-7000
(864) 987-7020
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
(864) 797-6198
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1165
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0265
—
SC
01
—
P01129674
RAILROAD MEDICARE
SC
Enumeration date
06/22/2005
Last updated
10/13/2015
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