Individual
CHANTALETTE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
3440 BLUE SPRINGS RD NW STE 503, KENNESAW, GA 30144-1038
(404) 857-9575
Mailing address
PO BOX 447, ELLABELL, GA 31308-0447
(912) 414-9923
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN248645
GA
363LP2300X
Primary Care Nurse Practitioner
RN248645
GA
Other
Enumeration date
12/03/2019
Last updated
07/14/2020
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