Individual
TANNER BRADLEY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3643 N ROXBORO ST, DURHAM, NC 27704-2702
(919) 470-4000
Mailing address
3643 N ROXBORO ST, DURHAM, NC 27704-2702
(614) 946-8045
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN.523092
OH
Other
Enumeration date
12/23/2024
Last updated
03/16/2025
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