Individual
MICHELLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2118 25TH ST STE E, COLUMBUS, IN 47201-3240
(812) 373-2727
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28164095A
IN
Other
Enumeration date
01/26/2022
Last updated
09/09/2024
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