Individual
MRS. RENEE CANNON SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10901 WILSON BLVD, BLYTHEWOOD, SC 29016-9241
(803) 691-4090
(803) 691-4097
Mailing address
10901 WILSON BLVD, BLYTHEWOOD, SC 29016-9241
(803) 691-4090
(803) 691-4097
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
62013
SC
Other
Enumeration date
02/11/2013
Last updated
02/11/2013
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