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Individual

CHANELLE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
9248 PIEDMONT ST, DETROIT, MI 48228-1727
(248) 914-2939
Mailing address
9248 PIEDMONT ST, DETROIT, MI 48228-1727
(248) 914-2939

Taxonomy

Speciality
Code
Description
License number
State
163WI0600X
Infection Control Registered Nurse
Primary
4704310023
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4704310023
REGISTERED NURSE LICENSE NUMBER
MI
Enumeration date
01/18/2021
Last updated
01/18/2021
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