Individual
MELISSA ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
2080 KEENELAND DR, BOGART, GA 30622-5917
(706) 255-8917
Mailing address
2080 KEENELAND DR, BOGART, GA 30622-5917
(706) 255-8917
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN145936
GA
Other
Enumeration date
09/30/2014
Last updated
09/30/2014
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