Individual
JESSICA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1010 HIGHWAY 17 N, NORTH MYRTLE BEACH, SC 29582-2806
(843) 685-0180
Mailing address
503 TRESTLE WAY, CONWAY, SC 29526-7468
(843) 685-0180
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4450
SC
Other
Enumeration date
02/15/2011
Last updated
03/04/2013
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