Individual
CARRIE RAE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
3681 N MAIN ST, FARMVILLE, NC 27828-1464
(252) 753-7141
(252) 753-5834
Mailing address
1850 W ARLINGTON BLVD, GREENVILLE, NC 27834-5704
(252) 752-6101
(252) 752-6600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-01679
NC
363AM0700X
Medical Physician Assistant
0010-01679
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750520664
—
NC
01
—
19BFW
BCBS NC
NC
Enumeration date
02/17/2009
Last updated
06/08/2016
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