Individual
SHANITA M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
(678) 212-6343
Mailing address
5587 WELLBORN CREEK DR, LITHONIA, GA 30058-3554
(973) 510-8552
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN227159
GA
Other
Enumeration date
04/07/2014
Last updated
04/07/2014
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