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Individual
AUTUMN ILENE SMITH
Active
Individual
AUTUMN ILENE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704297283
MI
363LA2100X
Acute Care Nurse Practitioner
4704297283NSA200T4
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704297283NSA200T4
APRN SPECIALTY CERTIFICATION
MI
Enumeration date
01/29/2021
Last updated
03/20/2023
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