MEDICARE: MRS. DEBORAH T SMOTHERS F.N.P.

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	APN0000006407	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467648949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH T SMOTHERS F.N.P.

Provider Business Mailing Address
First Line	:	PO BOX 416
Second Line	:
City	:	CAMDEN
State	:	TN
Zip	:	38320-0416
Country	:	US
Telephone Number	:	731-279-0600
Fax Number	:	731-279-0555

Provider Business Practice Location Address
First Line	:	160 HOSPITAL DR
Second Line	:
City	:	CAMDEN
State	:	TN
Zip	:	38320-1618
Country	:	US
Telephone Number	:	731-279-0600
Fax Number	:

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

Provider Enumeration Date	:	09/19/2007
Last Update Date	:	03/19/2018

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