Individual
JESSICA ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
105 DONNA KAY CT, BONAIRE, GA 31005-4333
(478) 220-1707
Mailing address
105 DONNA KAY CT, BONAIRE, GA 31005-4333
(478) 220-1707
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN219331
GA
Other
Enumeration date
07/02/2018
Last updated
07/02/2018
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