Individual
MATTHEW SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
940 S OCOEE ST, CLEVELAND, TN 37311-2601
(423) 479-5454
Mailing address
4705 FRONTAGE RD NW, CLEVELAND, TN 37312-2997
(423) 368-1251
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
25152
TN
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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