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Individual

JESSIE L SMILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(252) 752-2140
(252) 689-6502
Mailing address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(252) 752-2140
(252) 689-6502

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
159162
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
082171
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8053867
NC
01
P00742956
RAILROAD MEDICARE
NC
Enumeration date
06/04/2009
Last updated
12/19/2019
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