Provider Demographics
NPI:1881432854
Name:SMITH, RASHEDA GABRIELLE (FNP-C)
Entity type:Individual
Prefix:
First Name:RASHEDA
Middle Name:GABRIELLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29851-3336
Mailing Address - Country:US
Mailing Address - Phone:803-645-7340
Mailing Address - Fax:
Practice Address - Street 1:117 WARREN ST
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29851-3336
Practice Address - Country:US
Practice Address - Phone:803-645-7340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29025363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily