Individual
PHYLICIA DIANA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-PC
Contact information
Practice address
506 POLLOCK ST, NEW BERN, NC 28562-5612
(252) 288-6325
Mailing address
2721 RED WILLOW LN, WINSTON SALEM, NC 27127-7003
(336) 406-4188
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
5020638
NC
Other
Enumeration date
08/22/2024
Last updated
08/22/2024
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