Provider Demographics
NPI:1457689077
Name:SMITH, WHITNEY ANN (ANP, ADULT HEALTH)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:ANP, ADULT HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1971 ARMORY DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-9489
Mailing Address - Country:US
Mailing Address - Phone:678-939-6527
Mailing Address - Fax:
Practice Address - Street 1:966 HOUSTON NORTHCUTT BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3487
Practice Address - Country:US
Practice Address - Phone:843-388-6334
Practice Address - Fax:843-388-4197
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN.1768RX363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health