Basic Information
| Provider Information | |||||||||
| NPI: | 1962813592 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | LAKEE | ||||||||
| MiddleName: | |||||||||
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| Credential: | DNP, ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 COMMERCE ST STE 700 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372011835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8444622677 | ||||||||
| FaxNumber: | 8557375542 | ||||||||
| Practice Location | |||||||||
| Address1: | 2425 WEST LOOP S STE 200 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770274208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8444622677 | ||||||||
| FaxNumber: | 8557375542 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2014 | ||||||||
| LastUpdateDate: | 03/12/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP125360 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | AP60579127 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.