Individual
KELLY H SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
975 E. THIRD STREET, CHATTANOOGA, TN 37403-2147
(423) 778-7608
(423) 778-2360
Mailing address
PO BOX 11225, CHATTANOOGA, TN 37401-2225
(423) 892-5602
(423) 892-5838
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-105660
AL
163W00000X
Registered Nurse
RN169779
TN
367500000X
Certified Registered Nurse Anesthetist
1-105660
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
APN16079
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003116099A
—
GA
05
—
133602
—
AL
01
—
4308816
BCBS OF TN
TN
Enumeration date
08/18/2011
Last updated
03/21/2016
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