Individual
JESSICA LAUREN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
15612 GAYLORD, REDFORD, MI 48239-3978
(313) 686-1057
Mailing address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
4704365548
MI
Other
Enumeration date
06/05/2024
Last updated
06/05/2024
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