Individual
JENNIFER NICOLE ALEXANDRA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-5102
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6965
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
12373
GA
363AM0700X
Medical Physician Assistant
Primary
1102095
CA
Other
Enumeration date
11/30/2011
Last updated
09/13/2024
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