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General NPI Number Information
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NPI Number | 1306098884
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Entity Type | Individual
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Provider Name | LORA ANN DECKARD-SMART APRN
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Gender | Female
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 660 S MOUNT JULIET RD STE 130
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City | MT JULIET
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State | TN
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Zip | 37122-6496
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Country | US
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Telephone | 865-588-3173
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Fax |
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Provider Business Mailing Address
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Address Line | CMR 402 PO BOX 1559
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City | LANDSTUHL
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State | EUROPE
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Zip | 09180
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Country | DE
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Telephone | 015121324163
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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 | 0000111136
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 13606
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License Number State | TN
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