Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 51846 | GA |
NPI | 1144395641 |
---|---|
Provider Name | Natasha Smith |
First Address | Atlanta, GA 30303-1401 |
Second Address | Riverdale, GA 30274-2615 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 29/08/2013 |