Individual
JACQUITA DEADRA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
201 JORDAN RD STE 200, FRANKLIN, TN 37067-4495
(731) 847-1428
Mailing address
113 SUGARBERRY DR NE, MILLEDGEVILLE, GA 31061-8069
(478) 363-5428
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN275254
GA
Other
Enumeration date
03/29/2023
Last updated
03/29/2023
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