Smart, Kelly M

Smart, Kelly M is an individual health care provider with primary practice located at 141 Hillcrest Dr , Clarksville TN 37043. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Smart, Kelly M can be contacted via phone (931) 552-4340.

Contact Information

Primary practice address
141 Hillcrest Dr Clarksville TN 37043
Phone: (931) 552-4340
Fax: (931) 552-0999
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA1125 Tennessee

Profile Details

NPI number 1720081532
LBN Legal business name Smart, Kelly M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated Oct 31st, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720081532 NPPES
Tennessee MEDICAID 620862316
Tennessee MEDICAID 3663312
Tennessee Other 9500536900

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