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Individual

MRS. MARTHA DELLE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1818 ALBION ST, NASHVILLE, TN 37208-2918
(404) 357-1612
Mailing address
2035 VALENCIA TER, CHARLOTTE, NC 28226-3312
(404) 357-1612

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
12378
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
240346
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3600064
TN
05
36000641
TN
01
4155771
BCBS
TN
01
7100012730
KY MEDICAID
KY
05
8053870
NC
05
NAN973
SC
Enumeration date
03/20/2007
Last updated
09/13/2011
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