Individual
JESSE THOMAS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
7 INDEPENDENCE PT STE 300, GREENVILLE, SC 29615-4569
(864) 522-3700
(864) 522-3705
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
102323
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
17824
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
089906
AANA CERTIFICATION
SC
Enumeration date
05/01/2012
Last updated
12/29/2021
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