Healthcare Provider Details

I. General information

NPI: 1659302180
Provider Name (Legal Business Name): EVELYN W SMITH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 05/10/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 UNDERPASS DR
ONEIDA TN
37841-5885
US

IV. Provider business mailing address

281 UNDERPASS DR
ONEIDA TN
37841-5885
US

V. Phone/Fax

Practice location:
  • Phone: 423-569-5454
  • Fax: 423-569-5858
Mailing address:
  • Phone: 423-569-5454
  • Fax: 423-569-5858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN0000056665
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN 5692
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: