Provider Demographics
NPI:1316907199
Name:SMITH, CORINE WAITE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:CORINE
Middle Name:WAITE
Last Name:SMITH
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MS
Other - First Name:CORINE
Other - Middle Name:WAITE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:38 N PERSHING RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-1341
Mailing Address - Country:US
Mailing Address - Phone:828-298-7911
Mailing Address - Fax:828-299-5992
Practice Address - Street 1:1100 TUNNEL RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2043
Practice Address - Country:US
Practice Address - Phone:828-298-7911
Practice Address - Fax:828-299-5992
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY354472-1163WP0808X
NYF400169-1363LP0808X
NYF333210-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily