Lynne D Smith, F.N.P.-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN60915 Issued in GA

Practice address

119 Norman Dorminy Dr Ste a
Fitzgerald, GA 31750-9069

Phone

(229) 423-5437

Fax

(229) 424-0868

NPI assigned

Apr 13, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1689638124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749",
            "city": "OCILLA",
            "state": "GA",
            "postal_code": "317740749",
            "telephone_number": "229-468-9166",
            "fax_number": "229-468-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 NORMAN DORMINY DR STE A",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317509069",
            "telephone_number": "229-423-5437",
            "fax_number": "229-424-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LYNNE",
        "middle_name": "D",
        "credential": "F.N.P.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN60915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000580522C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000580522D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Antonio R Sison, M.D.
• Smile Mission Fitzgerald LLC
• Anna Nicole Smith
• John Smith
• Judith Elaine Smith, M.DIV
• Kelly R. Sosebee, MHE,SLP
• South Central Primary Care Center, Inc
• South Central Primary Care Center, Inc
• South Central Primary Care Center, Inc
• South Central Primary Care Center, Inc

• Family Nurse Practitioner in Fitzgerald, GA
• Providers in Fitzgerald, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.