Individual
CHARNIECE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
307 W COTA ST, SHELTON, WA 98584-2265
(360) 205-8004
(360) 839-2820
Mailing address
2300 MANCHESTER EXPY STE 2001A, COLUMBUS, GA 31904-6802
(706) 320-3126
(706) 320-3054
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61154507
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN232587
GA
Other
Enumeration date
01/02/2020
Last updated
08/07/2024
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