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Individual

HEATHER SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
7460 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1760
(901) 763-0200
(901) 761-4002
Mailing address
P O BOX 1000, DEPT 960, MEMPHIS, TN 38148
(901) 763-0200
(901) 761-4002

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
15872
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
APN0000015872
APN LICENSE
UT
01
R886682
RN LICENSE
TN
Enumeration date
09/08/2011
Last updated
11/28/2016
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