Provider Demographics
NPI:1992134357
Name:SMITH, JUDSON ROBERT (NP)
Entity type:Individual
Prefix:MR
First Name:JUDSON
Middle Name:ROBERT
Last Name:SMITH
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 WINBERRY DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-6219
Mailing Address - Country:US
Mailing Address - Phone:315-323-1784
Mailing Address - Fax:
Practice Address - Street 1:2300 PATTERSON ST
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1538
Practice Address - Country:US
Practice Address - Phone:615-342-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18077363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily