Individual
KEIUNDRA NICHOLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7064 OAKBROOK DR, COLUMBUS, GA 31909-6013
(470) 445-4029
Mailing address
7064 OAKBROOK DR, COLUMBUS, GA 31909-6013
(470) 445-4029
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
581330
—
GA
01
—
581331
PRIVATE SERVICE
GA
Enumeration date
01/23/2023
Last updated
01/23/2023
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