Individual
TARA C SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1945 GLENNS BAY RD, SURFSIDE BEACH, SC 29575-4833
(843) 650-4006
Mailing address
1945 GLENNS BAY RD, SURFSIDE BEACH, SC 29575-4833
(843) 650-4006
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20036
SC
Other
Enumeration date
04/12/2016
Last updated
07/06/2021
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