Provider Demographics
NPI:1659871309
Name:SMITH, GLENNA NOELLE ARMISTEAD (NP)
Entity type:Individual
Prefix:
First Name:GLENNA
Middle Name:NOELLE ARMISTEAD
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10469 ATLEE STATION RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-8913
Mailing Address - Country:US
Mailing Address - Phone:804-923-4002
Mailing Address - Fax:
Practice Address - Street 1:10469 ATLEE STATION RD STE 100
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-8913
Practice Address - Country:US
Practice Address - Phone:804-944-2605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2025-05-13
Deactivation Date:2018-02-20
Deactivation Code:
Reactivation Date:2018-02-27
Provider Licenses
StateLicense IDTaxonomies
VA0024175870363LF0000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily