Individual
CALLIE RENE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
16126 NC HWY 50 NORTH, GARNER, NC 27529
(919) 235-1425
Mailing address
PO BOX 803854, KANSAS CITY, MO 64180-3854
(919) 350-0351
(919) 350-7686
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-16435
NC
363AM0700X
Medical Physician Assistant
Primary
0010-16435
NC
363AM0700X
Medical Physician Assistant
Primary
—
NC
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255154563
—
NC
Enumeration date
11/05/2024
Last updated
04/10/2026
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