Provider Demographics
NPI:1366337545
Name:SMITH, KAREN CHEREE (AGNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:CHEREE
Last Name:SMITH
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 AVALON PARK CIR APT 107
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9560
Mailing Address - Country:US
Mailing Address - Phone:704-500-3725
Mailing Address - Fax:
Practice Address - Street 1:515 S GENERALS BLVD
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3656
Practice Address - Country:US
Practice Address - Phone:704-735-8065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5022334363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology