Individual
KIM W SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP C
Contact information
Practice address
5817 TUCKERTOWN LN, FAYETTEVILLE, NC 28314-1375
(336) 339-1163
Mailing address
5817 TUCKERTOWN LN, FAYETTEVILLE, NC 28314-1375
(336) 339-1163
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
132460
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7004844
—
NC
Enumeration date
11/02/2009
Last updated
12/08/2013
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