IDA SMITH

FAYETTEVILLE, GA
NPI1336525138
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: GA  RN128300)
Enumeration Date2015-08-04
Last Update Date2015-08-04
Business Address
-- IDA SMITH NP
1260 HIGHWAY 54 W STE 101
FAYETTEVILLE, GA 30214-4525
Phone number: 770-719-4620
Mailing Address
-- IDA SMITH NP
2375 LAGO DR
JONESBORO, GA 30236-5251
Phone number: 770-478-4048
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