Individual
MRS. CAROL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9075 SANDIDGE CENTER COVE, OLIVE BRANCH, MS 38654
(662) 895-4949
(662) 895-6776
Mailing address
655 EDEN BROOK LN, MEMPHIS, TN 38108
(901) 757-5308
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RN0000028175
MS
Other
Enumeration date
10/18/2005
Last updated
04/09/2013
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