Individual
BLAKE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
80 ENOCH BLVD, SAVANNAH, TN 38372
(731) 926-9600
Mailing address
3285 OAKLEY RD, SAVANNAH, TN 38372-3807
(731) 698-1061
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
RN0000161004
TN
363LP2300X
Primary Care Nurse Practitioner
Primary
24523
TN
Other
Enumeration date
10/19/2009
Last updated
08/29/2018
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