Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 5010904 | NC |
N | 363LP2300X | Nurse Practitioner - Primary Care | 5010904 | NC |
NPI | 1558842575 |
---|---|
Provider Name | Erin Marett Smith |
First Address | Kenly, NC 27542-8149 |
Second Address | Smithfield, NC 27577-4407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2018 |
Last Update Date | 27/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5010904 | NORTH CAROLINA BOARD OF NURSING NP LICENSE (01) | NC |