Individual
AMY ELIZABETH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
900 PEELER ST, KALAMAZOO, MI 49008-2300
(269) 345-8618
(269) 345-1508
Mailing address
900 PEELER ST, KALAMAZOO, MI 49008-2300
(269) 345-8618
(269) 345-1508
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704253793
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704253793
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704253793
STATE LICENSE:
MI
Enumeration date
11/17/2015
Last updated
04/11/2016
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