Provider Demographics
NPI:1902497142
Name:SMITH, RUSSELL WILLIAM (DNP, FNP-C)
Entity type:Individual
Prefix:MR
First Name:RUSSELL
Middle Name:WILLIAM
Last Name:SMITH
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Gender:M
Credentials:DNP, FNP-C
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Mailing Address - Street 1:1835 SAVOY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1071
Mailing Address - Country:US
Mailing Address - Phone:678-288-9555
Mailing Address - Fax:678-288-9556
Practice Address - Street 1:550 PEACHTREE ST NE STE 1185
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2236
Practice Address - Country:US
Practice Address - Phone:404-223-0792
Practice Address - Fax:404-223-5815
Is Sole Proprietor?:No
Enumeration Date:2021-01-31
Last Update Date:2022-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN298954363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily