Individual
RACHEL M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6811 118TH AVE, KENOSHA, WI 53142-8420
(262) 857-5750
Mailing address
PO BOX 735031, CHICAGO, IL 60673-5031
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7214
WI
363LF0000X
Family Nurse Practitioner
7214-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100061116
—
WI
Enumeration date
08/24/2016
Last updated
01/15/2024
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