Provider Demographics
NPI:1942948369
Name:SMITH, ELIZABETH NADRA (FNP-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:NADRA
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3333 RIVERWOOD PKWY SE STE 250
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3304
Mailing Address - Country:US
Mailing Address - Phone:770-914-0116
Mailing Address - Fax:
Practice Address - Street 1:1240 EAGLES LANDING PKWY STE 110
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-5173
Practice Address - Country:US
Practice Address - Phone:770-389-3855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN085855363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN085855OtherSTATE BOARD OF NURSING
F05210353OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS NATIONAL CERTIFICATION BOARD