Individual
MARY ELIZABETH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
3815 HARRISON RD, LOGANVILLE, GA 30052-2462
(770) 466-6112
(770) 466-6012
Mailing address
980 LAWRENCEVILLE HWY, LAWRENCEVILLE, GA 30046-4706
(770) 962-8025
(770) 822-1573
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN178265
GA
Other
Enumeration date
05/21/2010
Last updated
05/21/2010
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