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Individual

NICOLE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
571 MEMORIAL AVE N, ALLENDALE, SC 29810-2713
(803) 584-3818
Mailing address
571 MEMORIAL AVE N, ALLENDALE, SC 29810-2713

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
221540
SC

Other

Enumeration date
05/20/2014
Last updated
05/20/2014
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