Provider Demographics
NPI:1982469573
Name:SMITH, AMBER (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials: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 1:201 W LIBERTY AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38019-2500
Mailing Address - Country:US
Mailing Address - Phone:901-296-8040
Mailing Address - Fax:901-339-1282
Practice Address - Street 1:201 W LIBERTY AVE STE 101
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:TN
Practice Address - Zip Code:38019-2500
Practice Address - Country:US
Practice Address - Phone:901-296-8040
Practice Address - Fax:901-339-1282
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35298363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily