Provider Demographics
NPI:1548812282
Name:NESMITH, ANDREW DENNIS (FNP)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:DENNIS
Last Name:NESMITH
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 HIGH POINT RD NW
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-7068
Mailing Address - Country:US
Mailing Address - Phone:478-234-5388
Mailing Address - Fax:
Practice Address - Street 1:601 SOUTH 8TH ST
Practice Address - Street 2:EMERGENCY ROOM
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224
Practice Address - Country:US
Practice Address - Phone:770-228-2721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN233162163W00000X, 363LF0000X
GAF06190587363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse