Provider Demographics
NPI:1154907327
Name:SMITH, TERNITA LASHARNE (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:TERNITA
Middle Name:LASHARNE
Last Name:SMITH
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 NE CHAMBERS CT
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32055-3587
Mailing Address - Country:US
Mailing Address - Phone:386-965-6108
Mailing Address - Fax:
Practice Address - Street 1:216 SE CORRECTIONS WAY
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-2013
Practice Address - Country:US
Practice Address - Phone:386-754-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9204000363LP0808X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health