Provider Demographics
NPI:1487835401
Name:SMITHEY, SEAN EDWARD (MSN, ACNP-BC)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:EDWARD
Last Name:SMITHEY
Suffix:
Gender:M
Credentials:MSN, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 W 4TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2489
Mailing Address - Country:US
Mailing Address - Phone:931-372-0405
Mailing Address - Fax:931-783-5049
Practice Address - Street 1:106 HENRY AVE
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-4470
Practice Address - Country:US
Practice Address - Phone:931-783-4770
Practice Address - Fax:931-484-9616
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000012984363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1521537Medicaid