Provider Demographics
NPI:1013481852
Name:SMITH, CAROLEE JAYNE (APRN,NP-FAMILY)
Entity Type:Individual
Prefix:
First Name:CAROLEE
Middle Name:JAYNE
Last Name:SMITH
Suffix:
Gender:F
Credentials:APRN,NP-FAMILY
Other - Prefix:
Other - First Name:CAROLE
Other - Middle Name:JAYNE
Other - Last Name:STARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:80 ROUTE 125
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NH
Mailing Address - Zip Code:03848-3535
Mailing Address - Country:US
Mailing Address - Phone:603-642-6700
Mailing Address - Fax:
Practice Address - Street 1:80 ROUTE 125
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NH
Practice Address - Zip Code:03848-3535
Practice Address - Country:US
Practice Address - Phone:603-642-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-15
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH053465-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily