Provider Demographics
NPI:1437910361
Name:SMITH, ERIN KELLY (FNP-C)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:KELLY
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 BELLA BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BROADWAY
Mailing Address - State:NC
Mailing Address - Zip Code:27505-8549
Mailing Address - Country:US
Mailing Address - Phone:973-600-8310
Mailing Address - Fax:
Practice Address - Street 1:2277 NC 24 # 87
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:NC
Practice Address - Zip Code:28326-7671
Practice Address - Country:US
Practice Address - Phone:919-373-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5019453363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily