Individual
JASON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
1968 PEACHTREE RD NW, ATLANTA, GA 30309-1285
(404) 367-3014
Mailing address
1968 PEACHTREE RD NW, ATLANTA, GA 30309-1285
(404) 367-3014
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP60933179
WA
363LA2100X
Acute Care Nurse Practitioner
AP60933179
WA
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
RN214460
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962883249
—
WA
Enumeration date
06/12/2015
Last updated
05/13/2022
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