Individual
MRS. AUTUMN PEREIDA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
90 SOUTHSIDE AVE, SUITE 350, ASHEVILLE, NC 28801-4160
(828) 277-4810
Mailing address
90 SOUTHSIDE AVE, SUITE 350, ASHEVILLE, NC 28801-4160
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102706
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1559Y
BCBS NC
NC
05
—
1871743211
—
NC
Enumeration date
09/23/2008
Last updated
12/08/2016
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