Provider Demographics
NPI:1831430867
Name:SMITH, MELODY LEE (LPN)
Entity type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:LEE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:MELODY
Other - Middle Name:LEE
Other - Last Name:KITCHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1237 JACKSONS VIEW RD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3331
Mailing Address - Country:US
Mailing Address - Phone:615-347-5347
Mailing Address - Fax:
Practice Address - Street 1:260 CUMBERLAND BND
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1804
Practice Address - Country:US
Practice Address - Phone:615-726-3340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN82709164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse