Individual
KELLY HANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
4109 WAKE FOREST RD STE 300, RALEIGH, NC 27609-2508
(919) 250-3478
(919) 250-6272
Mailing address
4109 WAKE FOREST RD STE 300, RALEIGH, NC 27609-2508
(919) 250-3478
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
5018023
NC
363LP0200X
Pediatric Nurse Practitioner
0024177340
VA
363LP0200X
Pediatric Nurse Practitioner
Primary
5018023
NC
Other
Enumeration date
02/22/2019
Last updated
08/22/2024
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