Basic Information
| Provider Information | |||||||||
| NPI: | 1316907199 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | CORINE | ||||||||
| MiddleName: | WAITE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NURSE PRACTITIONER | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SMITH | ||||||||
| OtherFirstName: | CORINE | ||||||||
| OtherMiddleName: | WAITE | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | NURSE PRACTITIONER | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 38 N PERSHING RD | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288051341 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282987911 | ||||||||
| FaxNumber: | 8282995992 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 TUNNEL RD | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288052043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282987911 | ||||||||
| FaxNumber: | 8282995992 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 354472-1 | NY | X | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 363LP0808X | F400169-1 | NY | X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LF0000X | F333210-1 | NY | X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.