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NPI Code Detail

MEDICARE: CRYSTAL DIANE SMITH NP-C

MEDICARE: CRYSTAL DIANE SMITH NP-C
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
1363L00000XNurse Practitioner0000021742TN

General Provider Information

NPI Number : 1356893259
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL DIANE SMITH NP-C
Provider Business Mailing Address
First Line : 2620 ELM HILL PIKE
Second Line :
City : NASHVILLE
State : TN
Zip : 37214-3108
Country : US
Telephone Number : 615-425-4200
Fax Number : 615-425-4201
Provider Business Practice Location Address
First Line : 11635 HIGHWAY 70
Second Line :
City : ARLINGTON
State : TN
Zip : 38002-9778
Country : US
Telephone Number : 901-290-9260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2016
Last Update Date : 11/08/2016

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Directions to “ CRYSTAL DIANE SMITH NP-C” Practice Location

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