MEDICARE: JULIA MARIE SMYTH PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	7110	TN

General Provider Information

NPI Number	:	1164354015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA MARIE SMYTH PA-C

Provider Business Mailing Address
First Line	:	1161 21ST AVE S
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37232-0011
Country	:	US
Telephone Number	:	615-343-4612
Fax Number	:

Provider Business Practice Location Address
First Line	:	1211 21ST AVE S
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37212-2717
Country	:	US
Telephone Number	:	615-343-4612
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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