Smith, Alicia Louise

Smith, Alicia Louise is an individual health care provider with primary practice located at 140 Three Rivers Dr Ne , Rome GA 30161-4999. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Smith, Alicia Louise can be contacted via phone (706) 232-1300.

Contact Information

Primary practice address
140 Three Rivers Dr Ne Rome GA 30161-4999
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X RN192262 Georgia

Profile Details

NPI number 1396979621
LBN Legal business name Smith, Alicia Louise
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 14th, 2009
Last updated Sep 14th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396979621 NPPES
Georgia MEDICAID 299653708A

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