Male or Other

Mr. Jeremiah S. Smith NP

Acute Care Nurse Practitioner in Chattanooga, TN(View on Map)

Full Name

Mr. Jeremiah Shane Smith NP

NPI Number

1790039188

NPI Type

Individual Provider

Gender

Male

Enumeration Date

11/07/2012

Specialties

(Taxonomies)

Code

363LA2100X

Primary Taxonomy

Yes

Licenses

State

Tennessee
Tennessee

License Number

16902
APN0000016902

Contact
Information

Purpose

Mailing
Location

Address

1949 GUNBARREL ROAD
605 GLENWOOD DRIVE, SUITE 105

City

Chattanooga
Chattanooga

State

TN
TN

Postal Code

37421
37404

Country

US
US

Telephone Number

(423) 495-4349
(423) 495-5864

Identifiers

Identifier

16902

Identifier State

TN

Identifier Issuer

APN LICENSE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/21/2022

Provider Address

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