Individual
TARA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
190 INDEPENDENCE DR, ROEBUCK, SC 29376-3335
(812) 457-1738
Mailing address
4762 MAPLE SPRING CT, AUGUSTA, GA 30907-1258
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
28134485A
IN
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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