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Individual

NICOLE CHRISTINA SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-CNM

Contact information

Practice address
300 HEALTH PARK BLVD STE 3002, ST AUGUSTINE, FL 32086-3703
(937) 802-7771
Mailing address
PO BOX 748817, ATLANTA, GA 30374-8817
(813) 286-0033
(813) 282-1806

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
APRN11019008
FL
367A00000X
Advanced Practice Midwife
Primary
APRN11019008
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
236040352
MEDICARE PTAN
IN
05
300045317
IN
Enumeration date
08/26/2020
Last updated
02/05/2024
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