Individual
MR. JEREMIAH SHANE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
605 GLENWOOD DRIVE, SUITE 105, CHI MEMORIAL THORACIC ONCOLOGY ASSOCIATES, CHATTANOOGA, TN 37404
(423) 495-5864
(423) 495-2065
Mailing address
1949 GUNBARREL ROAD, SUITE 230, CHATTANOOGA, TN 37421
(423) 495-4349
(423) 495-4934
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
16902
TN
363LA2100X
Acute Care Nurse Practitioner
APN0000016902
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16902
APN LICENSE
TN
Enumeration date
11/07/2012
Last updated
07/21/2022
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