Provider Demographics
NPI:1306098884
Name:DECKARD-SMART, LORA ANN (APRN)
Entity type:Individual
Prefix:
First Name:LORA
Middle Name:ANN
Last Name:DECKARD-SMART
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 402 PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:LANDSTUHL
Mailing Address - State:EUROPE
Mailing Address - Zip Code:09180
Mailing Address - Country:DE
Mailing Address - Phone:01512-132-4163
Mailing Address - Fax:
Practice Address - Street 1:660 S MOUNT JULIET RD STE 130
Practice Address - Street 2:
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-6496
Practice Address - Country:US
Practice Address - Phone:865-588-3173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000111136363LF0000X
TN13606363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily