Provider Demographics
NPI:1053172932
Name:SMYTHE, REAGAN BEGLEY (BSN-RN)
Entity type:Individual
Prefix:MRS
First Name:REAGAN
Middle Name:BEGLEY
Last Name:SMYTHE
Suffix:
Gender:F
Credentials:BSN-RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 SWANNANOA AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37664-3631
Mailing Address - Country:US
Mailing Address - Phone:423-765-7570
Mailing Address - Fax:
Practice Address - Street 1:2303 INDIAN RIDGE RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-4282
Practice Address - Country:US
Practice Address - Phone:423-328-8476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN255505163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool