Individual
SOPHIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
N20W22961 WATERTOWN RD, WAUKESHA, WI 53186-1306
(262) 875-5070
Mailing address
211 N WILLSON DR, ALTOONA, WI 54720-2199
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11415-33
WI
Other
Enumeration date
10/26/2021
Last updated
11/11/2023
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