Individual
MRS. KIMBERLEY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
623 COUNTRY DAY RD, GOLDSBORO, NC 27530-8888
(919) 330-1940
Mailing address
623 COUNTRY DAY RD, GOLDSBORO, NC 27530-8888
(919) 330-1940
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5007058
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5007058
NP LICENSE
NC
01
—
MM3255862
DEA
NC
Enumeration date
05/27/2014
Last updated
02/02/2024
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