Individual
SANDRA DOREEN SMITH-KIRBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
3504 LANGSTON BLVD, WINTERVILLE, NC 28590-9314
(252) 258-2370
(252) 752-8555
Mailing address
3504 LANGSTON BLVD, WINTERVILLE, NC 28590-9314
(252) 258-2370
(252) 752-8555
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5010887
NC
363LG0600X
Gerontology Nurse Practitioner
Primary
5010887
NC
Other
Enumeration date
03/29/2018
Last updated
09/19/2018
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