Provider Demographics
NPI:1053402339
Name:SMITH, KIMBERLY M (APN)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:MORGAN
Other - Last Name:CALNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:4713 PAPERMILL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1924
Mailing Address - Country:US
Mailing Address - Phone:865-851-7771
Mailing Address - Fax:865-851-7835
Practice Address - Street 1:4713 PAPERMILL DR STE 100
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1924
Practice Address - Country:US
Practice Address - Phone:865-851-7771
Practice Address - Fax:865-851-7835
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN7427363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1530375Medicaid
TN1530375Medicaid