Provider Demographics
NPI:1104264738
Name:SMITH, MARY KATHERINE (FNP)
Entity type:Individual
Prefix:MISS
First Name:MARY
Middle Name:KATHERINE
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Mailing Address - Street 1:1718 PATTERSON ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2926
Mailing Address - Country:US
Mailing Address - Phone:615-346-8546
Mailing Address - Fax:615-320-1948
Practice Address - Street 1:333 COMMERCE ST
Practice Address - Street 2:SUITE 700
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37201-1826
Practice Address - Country:US
Practice Address - Phone:615-346-8468
Practice Address - Fax:888-972-4927
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN0000017500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily