Healthcare Provider Details

I. General information

NPI: 1467648949
Provider Name (Legal Business Name): DEBORAH T SMOTHERS F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2007
Last Update Date: 03/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 HOSPITAL DR
CAMDEN TN
38320-1618
US

IV. Provider business mailing address

PO BOX 416
CAMDEN TN
38320-0416
US

V. Phone/Fax

Practice location:
  • Phone: 731-279-0600
  • Fax:
Mailing address:
  • Phone: 731-279-0600
  • Fax: 731-279-0555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000006407
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: