Provider Demographics
NPI:1073863486
Name:SMITH, AIMEE DAVIS (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:DAVIS
Last Name:SMITH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:MARIE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5512 OAKMONT CIR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-4635
Mailing Address - Country:US
Mailing Address - Phone:615-653-9003
Mailing Address - Fax:615-292-8424
Practice Address - Street 1:4301 HILLSBORO PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-3345
Practice Address - Country:US
Practice Address - Phone:615-383-6092
Practice Address - Fax:615-292-8424
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0000004028363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007271000Medicaid
FLGR887YMedicare PIN
FLGR887XMedicare PIN