Individual
MACKENZIE MAE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2124 KOHLER MEMORIAL DR STE 110, SHEBOYGAN, WI 53081-3174
(833) 821-7246
Mailing address
409 HURON ST, MANITOWOC, WI 54220-2932
(920) 905-1236
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11287-33
WI
Other
Enumeration date
09/08/2021
Last updated
07/06/2023
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