Provider Demographics
NPI:1326311838
Name:SMITH, SHEILA HARVEY (DNP, ANP, PMHNP)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:HARVEY
Last Name:SMITH
Suffix:
Gender:F
Credentials:DNP, ANP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 CYPRESS COMMONS WAY
Mailing Address - Street 2:
Mailing Address - City:CHOCOWINITY
Mailing Address - State:NC
Mailing Address - Zip Code:27817-8535
Mailing Address - Country:US
Mailing Address - Phone:252-402-9510
Mailing Address - Fax:877-940-2643
Practice Address - Street 1:110 CYPRESS COMMONS WAY
Practice Address - Street 2:
Practice Address - City:CHOCOWINITY
Practice Address - State:NC
Practice Address - Zip Code:27817-8535
Practice Address - Country:US
Practice Address - Phone:252-402-9510
Practice Address - Fax:877-940-2643
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005487363LA2200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7006027Medicaid