Individual
MRS. JENNIFER RENAULT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
830 S BUNCOMBE RD, GREER, SC 29650-2400
(864) 797-8000
Mailing address
1 INDEPENDENCE PT, STE 212, GREENVILLE, SC 29615-4545
(864) 797-6307
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3303
SC
367500000X
Certified Registered Nurse Anesthetist
ARNP790362
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366400871
RAILROAD MEDICARE NUMBER
FL
05
—
309089200
—
FL
01
—
G3844
BCBS
FL
01
—
Y3570
FL BXBS
FL
01
—
Y3570X
MEDICARE--MCAG
FL
Enumeration date
05/03/2006
Last updated
12/11/2013
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