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Individual

MICHAYLA DESIREE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
2790 GODWIN BLVD STE 305, SUFFOLK, VA 23434-8158
(757) 934-4222
Mailing address
2800 GODWIN BLVD, SUFFOLK, VA 23434-8038

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
314456
NC
363LF0000X
Family Nurse Practitioner
Primary
0024187456
VA

Other

Enumeration date
04/25/2023
Last updated
07/11/2024
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