Individual
LORA ANN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
MOUNTAIN HOME, LAMONT ST AND VETERANS WAY, JOHNSON CITY, TN 37604
(423) 926-1171
Mailing address
1107 WOODMONT DR, JOHNSON CITY, TN 37601-2641
(423) 773-3526
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
0000171856
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U36676
CM&F
TN
Enumeration date
10/20/2022
Last updated
10/20/2022
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