Individual
NICOLE L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9500 EUCLID AVE, MAIL CODE S80, CLEVELAND, OH 44195-0001
(216) 445-6677
Mailing address
5455 MEADOW WOOD BLVD, LYNDHURST, OH 44124-3757
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003134
OH
Other
Enumeration date
09/22/2010
Last updated
07/19/2013
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