Provider Demographics
NPI:1558818393
Name:SMITH, ADRIENNE (DNP, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1806
Mailing Address - Country:US
Mailing Address - Phone:908-339-8696
Mailing Address - Fax:908-747-1228
Practice Address - Street 1:114 S 2ND ST
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1806
Practice Address - Country:US
Practice Address - Phone:908-339-8696
Practice Address - Fax:908-747-1228
Is Sole Proprietor?:No
Enumeration Date:2016-09-09
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00658600363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health