Smith, Lisa S

Smith, Lisa S is an individual health care provider with primary practice located at 2085 Henry Tecklenburg Dr Fl 2 , Charleston SC 29414-7710. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Smith, Lisa S can be contacted via phone (843) 577-6957.

Contact Information

Primary practice address
2085 Henry Tecklenburg Dr Fl 2 Charleston SC 29414-7710
Fax: (843) 577-6523
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 696 South Carolina

Profile Details

NPI number 1952369043
LBN Legal business name Smith, Lisa S
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Oct 23rd, 2022 - about 3 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 1952369043 NPPES
South Carolina MEDICAID NP0147

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