Provider Demographics
NPI:1255333779
Name:SMITH, ERIN RENEE (FNP)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:RENEE
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:ERIN
Other - Middle Name:RENEE SMITH
Other - Last Name:BILTCLIFFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1309 YELLOWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8070
Mailing Address - Country:US
Mailing Address - Phone:803-329-6648
Mailing Address - Fax:803-985-4134
Practice Address - Street 1:1147 EBENEZER RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2355
Practice Address - Country:US
Practice Address - Phone:803-329-6648
Practice Address - Fax:803-985-4134
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC80869363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP2323Medicaid
SCNP0541Medicaid
SC7225Medicare ID - Type Unspecified
SCNP0541Medicaid