Provider Demographics
NPI:1295434702
Name:SMITH, TYLER JORDAN (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:MR
First Name:TYLER
Middle Name:JORDAN
Last Name:SMITH
Suffix:
Gender:M
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:156-239-2018
Mailing Address - Fax:
Practice Address - Street 1:125A HAVEN ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3622
Practice Address - Country:US
Practice Address - Phone:615-499-4545
Practice Address - Fax:615-499-4546
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-23
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN189673163W00000X
TN35560363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse