Healthcare Provider Details

I. General information

NPI: 1275008609
Provider Name (Legal Business Name): AMBER SMITH FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2018
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 GLENWOOD DR STE E780
CHATTANOOGA TN
37404-1177
US

IV. Provider business mailing address

7000 LEE HWY STE 600
CHATTANOOGA TN
37421-6729
US

V. Phone/Fax

Practice location:
  • Phone: 423-697-0072
  • Fax:
Mailing address:
  • Phone: 423-894-0432
  • Fax: 423-664-1011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number24551
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: