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General NPI Number Information
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NPI Number | 1003300351
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Entity Type | Individual
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Provider Name | CARLY MICHELLE SMITH NP
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Gender | Female
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 06/20/2019
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Provider Practice Location Address
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Address Line | 2416 21ST AVE S STE 201
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City | NASHVILLE
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State | TN
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Zip | 37212-5318
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Country | US
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Telephone | 615-582-6726
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Fax |
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Provider Business Mailing Address
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Address Line | 112 PAIGE PARK LN
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City | GOODLETTSVILLE
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State | TN
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Zip | 37072-3163
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Country | US
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Telephone | 615-420-0797
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 24339
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License Number State | TN
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