Individual
CANDICE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-2420
(414) 266-6837
Mailing address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-2420
(414) 266-6837
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6378-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306225008
—
WI
Enumeration date
05/27/2015
Last updated
06/05/2021
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