Individual
MS. CAROL LEE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN CRNP
Contact information
Practice address
1500 WOODROW WILSON, JACKSON, MS 39216-5199
(800) 949-1009
Mailing address
153 VINEYARD BLVD, BRANDON, MS 39047
(601) 291-9882
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-021304
AL
Other
Enumeration date
09/22/2006
Last updated
07/21/2022
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