Basic Information
Provider Information
NPI: 1982184966
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SMITH
FirstName: HELEN
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2004 HAYES ST STE 800
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372032659
CountryCode: US
TelephoneNumber: 6153290570
FaxNumber: 6157501728
Practice Location
Address1: 605 GLENWOOD DR STE 200
Address2:  
City: CHATTANOOGA
State: TN
PostalCode: 374041130
CountryCode: US
TelephoneNumber: 4236981844
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/18/2018
LastUpdateDate: 06/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
364SF0001X27492TNN Physician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
363LF0000X27492TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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