Individual
JEREMY LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, NP-C
Contact information
Practice address
4619 KANAWHA AVE SW, SOUTH CHARLESTON, WV 25309-1319
(304) 400-4545
Mailing address
4619 KANAWHA AVE SW, SOUTH CHARLESTON, WV 25309-1319
(304) 400-4545
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
81644
WV
363LF0000X
Family Nurse Practitioner
Primary
APRN81644-NP-C
WV
Other
Enumeration date
07/09/2015
Last updated
08/04/2025
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