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Individual

ASHLEY SMALLWOOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
5582 MEMORIAL DR, STONE MOUNTAIN, GA 30083-3215
(404) 564-6703
Mailing address
5582 MEMORIAL DR, STONE MOUNTAIN, GA 30083-3215
(044) 298-8998
(404) 298-7658

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN197976
GA
363LP0200X
Pediatric Nurse Practitioner
Primary
197976
GA

Other

Enumeration date
03/05/2019
Last updated
09/11/2020
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