Basic Information
| Provider Information | |||||||||
| NPI: | 1548812282 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NESMITH | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | DENNIS | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 494 HIGH POINT RD NW | ||||||||
| Address2: | |||||||||
| City: | MILLEDGEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 310617068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4782345388 | ||||||||
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| Practice Location | |||||||||
| Address1: | 601 SOUTH 8TH ST | ||||||||
| Address2: | EMERGENCY ROOM | ||||||||
| City: | GRIFFIN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7702282721 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2019 | ||||||||
| LastUpdateDate: | 07/12/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN233162 | GA | N | Nursing Service Providers | Registered Nurse | 363LF0000X | RN233162 | GA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | F06190587 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.