Provider Demographics
NPI:1295525434
Name:SMITH, KERI NICOLE (FNP-C)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:NICOLE
Last Name:SMITH
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:NICOLE
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:679 HILLMAN HWY
Mailing Address - Street 2:
Mailing Address - City:GLADE SPRING
Mailing Address - State:VA
Mailing Address - Zip Code:24340-2615
Mailing Address - Country:US
Mailing Address - Phone:276-525-0968
Mailing Address - Fax:
Practice Address - Street 1:679 HILLMAN HWY
Practice Address - Street 2:
Practice Address - City:GLADE SPRING
Practice Address - State:VA
Practice Address - Zip Code:24340-2615
Practice Address - Country:US
Practice Address - Phone:276-525-0968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-10
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001295088363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily