Healthcare Provider Details

I. General information

NPI: 1578377263
Provider Name (Legal Business Name): ALYONA SMITH AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 E LAMAR ALEXANDER PKWY
MARYVILLE TN
37804-5283
US

IV. Provider business mailing address

1812 E LAMAR ALEXANDER PKWY
MARYVILLE TN
37804-5283
US

V. Phone/Fax

Practice location:
  • Phone: 865-980-5200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number37511
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: