Basic Information
| Provider Information | |||||||||
| NPI: | 1780889634 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | MARIJA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | APRN-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9914 SHERETZ DR | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379231929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8654702448 | ||||||||
| FaxNumber: | 8657699510 | ||||||||
| Practice Location | |||||||||
| Address1: | 1120 E WEISGARBER RD | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379092685 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8659090090 | ||||||||
| FaxNumber: | 8659099883 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2007 | ||||||||
| LastUpdateDate: | 07/25/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 12742 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.