Provider Demographics
NPI:1407441132
Name:SMITH, GEORGEGTTE SHARI (BSN, RN)
Entity Type:Individual
Prefix:
First Name:GEORGEGTTE
Middle Name:SHARI
Last Name:SMITH
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 261
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:GA
Mailing Address - Zip Code:31331-0261
Mailing Address - Country:US
Mailing Address - Phone:912-399-3302
Mailing Address - Fax:
Practice Address - Street 1:7160 HODGSON MEMORIAL DR STE 103
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2563
Practice Address - Country:US
Practice Address - Phone:912-335-7383
Practice Address - Fax:912-349-6608
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2023-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN288150163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA84-3010027OtherMEDICAL EDUCATION TRAINING CENTER