Individual
JUSTIN ANDREW SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-CNP
Contact information
Practice address
924 CROSS LANES DR, CHARLESTON, WV 25313-1315
(304) 776-9872
Mailing address
5102 STAUNTON AVE SE, CHARLESTON, WV 25304-2139
(304) 859-3106
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
117094
WV
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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