Provider Demographics
NPI:1336871516
Name:SMITH, CARRIE ANN (CNM)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 MEDICAL PARK DR STE 304
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4779
Mailing Address - Country:US
Mailing Address - Phone:843-383-2764
Mailing Address - Fax:
Practice Address - Street 1:701 MEDICAL PARK DR STE 304
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4779
Practice Address - Country:US
Practice Address - Phone:843-383-2764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCL-317355163WL0100X
SC27417.RX367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant