Individual
NICKOLAS GRANT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
390 KEOWEE SCHOOL RD, SENECA, SC 29672-6780
(864) 885-7129
(864) 882-7240
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23620
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP7229
—
SC
Enumeration date
01/23/2020
Last updated
03/04/2024
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