Provider Demographics
NPI:1962883090
Name:SMITH, HOLLY CHRISTINE (RN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:CHRISTINE
Last Name:SMITH
Suffix:
Gender:
Credentials:RN, CPNP
Other - Prefix:
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Mailing Address - Street 1:175 WHITE ST NW STE 200
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7901
Mailing Address - Country:US
Mailing Address - Phone:770-487-3330
Mailing Address - Fax:770-487-7736
Practice Address - Street 1:175 WHITE ST NW STE 200
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7901
Practice Address - Country:US
Practice Address - Phone:770-487-3330
Practice Address - Fax:770-487-7736
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN234034363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics