Provider Demographics
NPI:1902077647
Name:SMITH, PAULA KILPATRICK (PA)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:KILPATRICK
Last Name:SMITH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 HAMPSTEAD VLG
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-8250
Mailing Address - Country:US
Mailing Address - Phone:910-270-3811
Mailing Address - Fax:910-270-3897
Practice Address - Street 1:75 HAMPSTEAD VLG
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-8250
Practice Address - Country:US
Practice Address - Phone:910-270-3811
Practice Address - Fax:910-270-3897
Is Sole Proprietor?:No
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2616103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist