Provider Demographics
NPI:1538857891
Name:SMALLEN, DANIEL JORDAN (RN)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JORDAN
Last Name:SMALLEN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:909 CARDING MACHINE RD
Mailing Address - Street 2:
Mailing Address - City:LOUDON
Mailing Address - State:TN
Mailing Address - Zip Code:37774-5627
Mailing Address - Country:US
Mailing Address - Phone:865-567-0274
Mailing Address - Fax:
Practice Address - Street 1:6473 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4832
Practice Address - Country:US
Practice Address - Phone:865-909-0090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN34049363LA2100X
TN208191163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine