Individual
SHANELLE MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
133 PARK ST, CARDIOLOGY DEPARTMENT, MALONE, NY 12953-1244
(518) 481-2545
Mailing address
133 PARK ST, MALONE, NY 12953-1244
(518) 481-2545
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
311418
NY
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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