Provider Demographics
NPI:1134427651
Name:SMITH, BRIDGETT N (APN)
Entity type:Individual
Prefix:
First Name:BRIDGETT
Middle Name:N
Last Name:SMITH
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 FORT SANDERS WEST BLVD
Mailing Address - Street 2:SUITE 308
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3398
Mailing Address - Country:US
Mailing Address - Phone:865-579-0552
Mailing Address - Fax:
Practice Address - Street 1:220 FORT SANDERS WEST BLVD
Practice Address - Street 2:SUITE 308
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3398
Practice Address - Country:US
Practice Address - Phone:865-579-0552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN150348363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily