Provider Demographics
NPI:1144506635
Name:SMOOT, STEVIE S (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:STEVIE
Middle Name:S
Last Name:SMOOT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:STEVIE
Other - Middle Name:S
Other - Last Name:SMOOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1747 MEDICAL CENTER PKWY STE 330
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2597
Mailing Address - Country:US
Mailing Address - Phone:615-603-8957
Mailing Address - Fax:
Practice Address - Street 1:1747 MEDICAL CENTER PKWY STE 330
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2597
Practice Address - Country:US
Practice Address - Phone:615-603-8957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21979363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN102I02980Medicare PIN