Provider Demographics
NPI:1821168014
Name:SMYTH, CAROLE A (NP)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:A
Last Name:SMYTH
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Gender:F
Credentials:NP
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Mailing Address - Street 1:1009 WINDCROSS CT
Mailing Address - Street 2:STE 101
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2678
Mailing Address - Country:US
Mailing Address - Phone:615-224-5438
Mailing Address - Fax:855-247-8787
Practice Address - Street 1:1 PENN PLZ
Practice Address - Street 2:STE 725
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10119-0002
Practice Address - Country:US
Practice Address - Phone:615-224-5438
Practice Address - Fax:855-247-8787
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2014-12-19
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Provider Licenses
StateLicense IDTaxonomies
NYF300167363L00000X
NY340563363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner