Individual
TAMMIE MICHELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNS-BC
Contact information
Practice address
1101 JACKSON ST SW, GRAVETTE, AR 72736-9121
(479) 787-5221
(479) 787-5613
Mailing address
2580 E JOYCE BLVD STE 1, FAYETTEVILLE, AR 72703-3924
(479) 305-7201
(479) 787-5613
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
S02236
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5R485
BCBS AR
—
01
—
P00853320
RR MEDICARE
AR
01
—
S02236
LIC
—
Enumeration date
05/14/2007
Last updated
09/11/2025
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