Provider Demographics
NPI:1649692419
Name:SMITH, COURTNEY S (FNP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:S
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:234 MORRELL RD STE 304
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5876
Mailing Address - Country:US
Mailing Address - Phone:865-246-0143
Mailing Address - Fax:865-246-0146
Practice Address - Street 1:300 PROSPERITY DR STE 103
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4717
Practice Address - Country:US
Practice Address - Phone:865-246-0143
Practice Address - Fax:865-246-0146
Is Sole Proprietor?:No
Enumeration Date:2014-01-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN18459363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily