Provider Demographics
NPI:1356973549
Name:SMITH, JUSTINE ANN (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:JUSTINE
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1533 COMMERCE AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-9128
Mailing Address - Country:US
Mailing Address - Phone:717-960-8956
Mailing Address - Fax:717-218-7557
Practice Address - Street 1:1533 COMMERCE AVE STE 2
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-9128
Practice Address - Country:US
Practice Address - Phone:717-960-8956
Practice Address - Fax:717-218-7557
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA574776163WC1500X
PASP027667363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health