Provider Demographics
NPI:1801140991
Name:SMITH, SONDRA JILL (RN)
Entity type:Individual
Prefix:
First Name:SONDRA
Middle Name:JILL
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:SONDRA
Other - Middle Name:JILL
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:2500 CHARLOTTE AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209
Mailing Address - Country:US
Mailing Address - Phone:615-340-7781
Mailing Address - Fax:
Practice Address - Street 1:2500 CHARLOTTE AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209
Practice Address - Country:US
Practice Address - Phone:615-340-7781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000077451163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool