Provider Demographics
NPI:1053873083
Name:SMITH, MADDISON BLAIR (FNP-BC)
Entity type:Individual
Prefix:
First Name:MADDISON
Middle Name:BLAIR
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MADDISON
Other - Middle Name:BLAIR
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:105 BUTTERCUP CV
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-6106
Mailing Address - Country:US
Mailing Address - Phone:615-804-2126
Mailing Address - Fax:
Practice Address - Street 1:1025 WESTHAVEN BLVD STE 210
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-4895
Practice Address - Country:US
Practice Address - Phone:615-721-5121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-31
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28445363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily