Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 0024180582 | VA |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 28488 | TN |
NPI | 1033715107 |
---|---|
Provider Name | Dr. Adriana Danielle Smith |
First Address | Kingsport, TN 37663-2130 |
Second Address | Memphis, TN 38134-7315 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2020 |
Last Update Date | 18/02/2021 |