Basic Information
| Provider Information | |||||||||
| NPI: | 1629249750 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SMALLHEER | ||||||||
| FirstName: | BENJAMIN | ||||||||
| MiddleName: | ALLAN | ||||||||
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| Credential: | PHD, RN, ACNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 GREAT CIRCLE RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372281317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152223449 | ||||||||
| FaxNumber: | 6152225322 | ||||||||
| Practice Location | |||||||||
| Address1: | 4220 HARDING PIKE | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372052005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152223449 | ||||||||
| FaxNumber: | 6152225322 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/17/2008 | ||||||||
| LastUpdateDate: | 01/26/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 10818 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
ID Information
| ID | Type | State | Issuer | Description | 4321885 | 01 | TN | BLUE CROSS-BLUE SHIELD | OTHER | P01039022 | 01 | TN | RR MEDICARE | OTHER | 1527495 | 05 | TN | MEDICAID |