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General NPI Number Information
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NPI Number | 1164720793
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Entity Type | Individual
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Provider Name | NANCY SMITH NP-C
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Gender | Female
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Dates
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Enumeration Date | 03/07/2011
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Last Update Date | 04/27/2015
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Provider Practice Location Address
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Address Line | 4485 W STONE DR SUITE 200
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City | KINGSPORT
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State | TN
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Zip | 37660-1050
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Country | US
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Telephone | 423-224-3150
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Fax | 423-224-3169
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Provider Business Mailing Address
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Address Line | 105 W STONE DR SUITE 6A
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City | KINGSPORT
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State | TN
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Zip | 37660-3365
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Country | US
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Telephone | 423-408-7220
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Fax | 423-408-7405
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 15698
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024169265
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 364SX0200X
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Taxonomy Name | Oncology Clinical Nurse Specialist
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License Number | 0024169265
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 364SX0200X
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Taxonomy Name | Oncology Clinical Nurse Specialist
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License Number | 15698
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License Number State | TN
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