Individual
KEVIN ANDREW SMALLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
11840 SOUTHMORE DR STE 100, CHARLOTTE, NC 28277-4821
(980) 308-0169
(980) 308-0173
Mailing address
PO BOX 601843, CHARLOTTE, NC 28260-1843
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5005854
NC
363LF0000X
Family Nurse Practitioner
217133
SC
Other
Enumeration date
07/23/2012
Last updated
07/22/2021
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