Provider Demographics
NPI:1063169449
Name:SMITHSON, CARRIE ANNE (RN, BSN)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANNE
Last Name:SMITHSON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 QUILL CT
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28083-6298
Mailing Address - Country:US
Mailing Address - Phone:704-245-5773
Mailing Address - Fax:
Practice Address - Street 1:2020 QUILL CT
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-6298
Practice Address - Country:US
Practice Address - Phone:704-245-5773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC307931163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse