Healthcare Provider Details

I. General information

NPI: 1235788167
Provider Name (Legal Business Name): LEAH N SMITH APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2019
Last Update Date: 01/22/2021
Certification Date: 12/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5651 FRIST BLVD STE 309
HERMITAGE TN
37076-2057
US

IV. Provider business mailing address

3443 DICKERSON PIKE STE 680
NASHVILLE TN
37207-2537
US

V. Phone/Fax

Practice location:
  • Phone: 615-250-6900
  • Fax: 615-250-6904
Mailing address:
  • Phone: 615-865-3322
  • Fax: 615-467-6692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number26353
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26353
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26353
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: