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Individual

SHELLY P SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
A.N.P.

Contact information

Practice address
3452 ANDERSON HWY, SUITE D, POWHATAN, VA 23139-5845
(804) 285-6050
(804) 598-2481
Mailing address
3452 ANDERSON HWY, SUITE D, POWHATAN, VA 23139-5845
(804) 285-6050
(804) 598-2481

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024164980
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C09633
GROUP PTAN
VA
Enumeration date
04/13/2006
Last updated
04/22/2013
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