MEDICARE: MISS MARY KATHERINE SMITH FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0000017500	TN

General Provider Information

NPI Number	:	1104264738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MARY KATHERINE SMITH FNP

Provider Business Mailing Address
First Line	:	1718 PATTERSON ST
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-2926
Country	:	US
Telephone Number	:	615-346-8546
Fax Number	:	615-320-1948

Provider Business Practice Location Address
First Line	:	333 COMMERCE ST
Second Line	:	SUITE 700
City	:	NASHVILLE
State	:	TN
Zip	:	37201-1826
Country	:	US
Telephone Number	:	615-346-8468
Fax Number	:	888-972-4927

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2013
Last Update Date	:	05/24/2019

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