Individual
QUETISHA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5825 GLENRIDGE DR BLDG 3, SUITE 108, ATLANTA, GA 30328
(470) 940-3394
Mailing address
5825 GLENRIDGE DR BLDG 3, SUITE 108, ATLANTA, GA 30328
(470) 940-3394
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN079293
GA
Other
Enumeration date
11/10/2023
Last updated
11/10/2023
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