Wanda Faye Smith, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

115705 Issued in TN

Practice address

126 East Main Street
Newbern, TN 38059

Phone

(731) 627-2221

Fax

(731) 627-2221

NPI assigned

Jul 29, 2010

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

• Wanda Faye Russell Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 29, 2010.

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280361600000",
    "number": "1982918264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 EAST MAIN STREET",
            "city": "NEWBERN",
            "state": "TN",
            "postal_code": "38059",
            "telephone_number": "731-627-2221",
            "fax_number": "731-627-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 EAST MAIN STREET",
            "city": "NEWBERN",
            "state": "TN",
            "postal_code": "38059",
            "telephone_number": "731-627-2221",
            "fax_number": "731-627-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WANDA",
        "middle_name": "FAYE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-29",
        "last_updated": "2010-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "115705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "RUSSELL",
            "middle_name": "FAYE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Newbern, TN
• Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.