Healthcare Provider Details

I. General information

NPI: 1811241458
Provider Name (Legal Business Name): R LAUREN SMITH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2012
Last Update Date: 11/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 GALE LN
NASHVILLE TN
37204-3012
US

IV. Provider business mailing address

2406 BELMONT BLVD # A
NASHVILLE TN
37212-5504
US

V. Phone/Fax

Practice location:
  • Phone: 615-298-5406
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number17053
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: