Individual
MISS KIMBERLY VICTORIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1035 SOUTHCREST DR STE 250, STOCKBRIDGE, GA 30281-6117
(770) 996-9945
(770) 996-7355
Mailing address
1035 SOUTHCREST DR STE 250, STOCKBRIDGE, GA 30281-6117
(770) 996-9945
(770) 996-7355
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN201498
GA
363LP2300X
Primary Care Nurse Practitioner
RN201498
GA
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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