Individual
KIM K. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 282-1480
(423) 928-1353
Mailing address
119 BOONE RIDGE DR, JOHNSON CITY, TN 37615-4998
(423) 282-1480
(423) 928-1353
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024165080
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015136910
—
VA
Enumeration date
07/13/2005
Last updated
10/14/2014
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